Oesophageal motility disorders in infected immigrants with Chagas disease in a non-endemic European area
Oesophageal motility disorders in infected immigrants with Chagas disease in a non-endemic European area
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DOI：
10.1177/2050640616630856
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发表时间：
2016-08-01
影响因子：
6
通讯作者：
Serra, Jordi
中科院分区：
文献类型：
--
作者：
Roure, Silvia;Valerio, Lluis;Serra, Jordi
背景
与移民相关的新疾病对接收国的医疗服务构成日益严峻的挑战。随着拉丁美洲移民的涌入，恰加斯病不可避免地出现在欧洲。
目的
利用高分辨率食管测压法（HREM）确定克氏锥虫感染移民中食管动力障碍的患病率和特征。
方法
对所有新诊断的伴有上消化道症状的慢性恰加斯病感染病例，进行规范化的临床评估以及包括食管钡餐造影和HREM在内的辅助检查。作为对照组，对来自同一流行地区的14名健康受试者进行HREM研究。
结果
我们纳入了61例患者（46例女性，15例男性；年龄范围26 - 63岁）。仅有7例患者（11%）的食管钡餐造影有轻微改变。相比之下，23例（37%）患者的食管测压显示有改变，主要是轻微动力障碍（34%）。仅有1名健康对照者（7%）在HREM中出现轻微动力障碍（与患者相比，p = 0.029）。
结论
恰加斯病感染移民中食管运动障碍较为常见，主要表现为食管钡餐造影无法检测到的轻微动力障碍。因此，除了食管钡餐造影检查外，还应考虑HREM，以评估这一特定患者群体的食管损伤情况。
Background Immigration-related new diseases pose a growing challenge for healthcare services in receptor countries. Following Latin American migration, Chagas disease has inevitably appeared in Europe.Aim To determine the prevalence and characteristics of oesophageal motility disorders in immigrants infected with Trypanosoma cruzi, using high resolution oesophageal manometry (HREM).Methods In all newly-diagnosed cases with chronic Chagas infection referring upper digestive symptoms, a protocolized clinical evaluation and complementary tests including barium oesophagogram and HREM were carried out. As control group, 14 healthy subjects from the same endemic areas were studied with HREM.Results We included 61 patients (46 female, 15 male; age range 26-63 years). Only seven patients (11%) had a minor alteration on barium oesophagogram. By contrast, 23 (37%) patients showed an alteration in oesophageal manometry, mainly minor motility disorders (34%). Only one healthy control (7%) had a minor motility disorder at HREM (p=0.029 vs. patients).Conclusions Oesophageal motor disorders in infected immigrants with Chagas disease are common, and mainly characterized by a minor motility disorder that is not detected by barium oesophagogram. Hence, as well as barium oesophagogram examination, HREM should be considered, to assess oesophageal damage in this specific group of patients.