Gastrointestinal Manifestations of Scleroderma: Recent Progress in Evaluation, Pathogenesis, and Management
Gastrointestinal Manifestations of Scleroderma: Recent Progress in Evaluation, Pathogenesis, and Management
复制标题
DOI：
10.1007/s11926-011-0217-3
复制
发表时间：
2012-02-01
影响因子：
5
通讯作者：
Baron, Murray
中科院分区：
文献类型：
--
作者：
Gyger, Genevieve;Baron, Murray
胃肠道 (GI) 受累在硬皮病（系统性硬化症 [SSc]）中很常见，也是该疾病最常见的内部并发症。胃肠道受累患者的生活质量受损，其预后可能是严重受损的一种。不幸的是，当严重并发症已经发生、不可逆转且难以处理时，人们常常会注意到胃肠道受累。过去 2 到 3 年有大量令人兴奋的研究，我们希望这些研究将有助于识别、预防、治疗和监测疾病进展。最近对胃肠道疾病病理生理学的研究可能会导致胃肠道受累治疗的进展。研究表明，几乎所有 SSc 患者都存在 GER 损伤，而且如果早期采用质子泵抑制剂治疗，GER 损伤是可逆的，这进一步强调了治疗胃食管反流 (GER) 的重要性。此外，最近的数据显示 SSc 患者中 GER 与间质性肺疾病之间的联系，强调了积极 GER 治疗对 SSc 患者的重要性。还描述了一种可能与 GER 有关的新型肺部模式。关于胃血管窦扩张的新的、令人兴奋的数据已经发表。最后，SSc 患者的营养不良和肛门直肠受累问题受到重视。
Gastrointestinal (GI) involvement is frequent in scleroderma (systemic sclerosis [SSc]) and is the most frequent internal complication of the disease. Patients with GI involvement have impaired quality of life, and their prognosis may be one of severe impairment. Unfortunately, GI involvement is often noticed when severe complications have already occurred, is irreversible, and is difficult to manage. The past 2 to 3 years have been rich in exciting studies that we hope will help identify, prevent, treat, and monitor disease progression. Recent studies on the pathophysiology of GI tract disease could lead to advances in the treatment of GI tract involvement. The importance of treating gastroesophageal reflux (GER) has been reinforced by studies showing GER damage in almost all SSc patients, and the fact that GER damage is reversible if early treatment with proton pump inhibitors is introduced. Moreover, recent data showing a link between GER and interstitial lung disease in SSc underscore the importance of aggressive GER treatment in SSc patients. A novel lung pattern possibly related to GER also has been described. New, exciting data on gastric vascular antral ectasia have been published. Finally, malnutrition in SSc patients has been highlighted, and anorectal involvement has been emphasized.