Gastrointestinal symptoms and motility disorders in patients with systemic scleroderma.
Gastrointestinal symptoms and motility disorders in patients with systemic scleroderma.
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DOI：
10.1186/1471-230x-8-7
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发表时间：
2008-02-27
影响因子：
2.4
通讯作者：
Portincasa P
中科院分区：
文献类型：
--
作者：
Di Ciaula A;Covelli M;Berardino M;Wang DQ;Lapadula G;Palasciano G;Portincasa P
到目前为止，系统性硬皮病的胃肠道症状、功能障碍和神经系统疾病的研究还很缺乏。对38例硬皮病患者(局限性34例，弥漫性4例)、60例健康对照组和68例消化不良对照组的上、下消化道症状(消化不良、排便习惯)、胃胆排空液体餐(功能超声)和小肠排空(H2呼气试验)进行评分。通过心血管试验评估自主神经功能。硬皮病患者的消化不良(主要是胃胀)得分高于健康对照组，但低于有多种症状的消化不良对照组。硬皮病伴消化不良患者病程较长。硬皮病患者空腹胃窦面积和餐后胃窦扩张均小于消化不良组和健康对照组。硬皮病患者(尤其是那些消化不良评分异常的患者)和消化不良对照组的胃排空都延迟，后者也显示出更大的残留区。尽管三组患者的空腹和餐后胆囊量相似，但在消化不良对照组中，胆囊再充盈似乎延迟，并且主要依赖于硬皮病患者胃排空的延迟。74%的硬皮病和66%的消化不良对照组的小肠传输也延迟。三组人的排便习惯相似。自主神经病变与消化不良、胃、胆运动和小肠运输无关。在硬皮病患者中，消化不良(主要是胃胀)、胃窦受限扩张和弥漫性胃肠动力障碍是常见的特征。这些缺陷与自主神经病变的发生无关。
Studies on gastrointestinal symptoms, dysfunctions, and neurological disorders in systemic scleroderma are lacking so far. Thirty-eight scleroderma patients (34 limited, 4 diffuse), 60 healthy controls and 68 dyspeptic controls were scored for upper and lower gastrointestinal symptoms (dyspepsia, bowel habits), gastric and gallbladder emptying to liquid meal (functional ultrasonography) and small bowel transit (H2-breath test). Autonomic nerve function was assessed by cardiovascular tests. The score for dyspepsia (mainly gastric fullness) was greater in scleroderma patients than healthy controls, but lower than dyspeptic controls who had multiple symptoms, instead. Scleroderma patients with dyspepsia had a longer disease duration. Fasting antral area and postprandial antral dilatation were smaller in scleroderma patients than dyspeptic and healthy controls. Gastric emptying was delayed in both scleroderma patients (particularly in those with abnormal dyspeptic score) and dyspeptic controls, who also showed a larger residual area. Despite gallbladder fasting and postprandial volumes were comparable across the three groups, gallbladder refilling appeared delayed in dyspeptic controls and mainly dependent on delayed gastric emptying in scleroderma. Small intestinal transit was also delayed in 74% of scleroderma and 66% of dyspeptic controls. Bowel habits were similar among the three groups. Autonomic neuropathy was not associated with dyspepsia, gastric and gallbladder motility and small intestinal transit. In scleroderma patients dyspepsia (mainly gastric fullness), restricted distension of the gastric antrum and diffuse gastrointestinal dysmotility are frequent features. These defects are independent from the occurrence of autonomic neuropathy.