Swallowing Disorders in Sjogren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life
Swallowing Disorders in Sjogren's Syndrome: Prevalence, Risk Factors, and Effects on Quality of Life
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DOI：
10.1007/s00455-015-9657-7
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发表时间：
2016-02-01
期刊：
影响因子：
2.6
通讯作者：
Roy, Nelson
中科院分区：
文献类型：
--
作者：
Pierce, Jenny L.;Tanner, Kristine;Roy, Nelson
这项流行病学调查研究了干燥综合征（SS）吞咽障碍的患病率、危险因素和对生活质量的影响。对101名原发性或继发性SS患者（94名女性，7名男性;平均年龄59.4岁，SD = 14.1）进行了吞咽障碍和症状的存在、性质和影响的访谈。吞咽障碍和症状、选择的医学和社会史因素、SS疾病严重程度和M.D.采用安德森吞咽困难量表（MDADI）和简明健康调查问卷（SF-36）进行调查。目前自我报告的吞咽障碍的患病率为64.4%。SS疾病的严重程度是吞咽障碍的最强预测因子，包括与以下吞咽症状的显著相关性：咬得更小，喉咙里有粘稠的粘液，难以将食物放入口中，以及进食时喘息（p <0.05）。其他吞咽障碍风险因素包括存在自我报告的声音障碍、食管反流、当前暴露于二手烟草烟雾、频繁颈部或咽喉紧张、频繁清咽、慢性鼻后滴漏和胃或十二指肠溃疡。吞咽障碍在原发性或继发性SS的基础上没有差异。吞咽障碍和特定的吞咽症状与生活质量下降唯一相关。在吞咽障碍的患者中，42%的人寻求治疗，其中约一半报告改善。患者感知的吞咽障碍在SS中相对常见，并随着疾病严重程度的增加而增加。特定的吞咽症状独特且显著地降低了吞咽和健康相关的生活质量，表明需要增加对该人群吞咽困难的识别和管理。
This epidemiological investigation examined the prevalence, risk factors, and quality-of-life effects of swallowing disorders in Sjogren's syndrome (SS). One hundred and one individuals with primary or secondary SS (94 females, 7 males; mean age 59.4, SD = 14.1) were interviewed regarding the presence, nature, and impact of swallowing disorders and symptoms. Associations among swallowing disorders and symptoms, select medical and social history factors, SS disease severity, and the M.D. Anderson Dysphagia Inventory (MDADI) and Short Form 36 Health Survey (SF-36) were examined. The prevalence of a current self-reported swallowing disorder was 64.4 %. SS disease severity was the strongest predictor of swallowing disorders, including significant associations with the following swallow symptoms: taking smaller bites, thick mucus in the throat, difficulty placing food in the mouth, and wheezing while eating (p < .05). Additional swallowing disorder risk factors included the presence of a self-reported voice disorder, esophageal reflux, current exposure to secondary tobacco smoke, frequent neck or throat tension, frequent throat clearing, chronic post-nasal drip, and stomach or duodenal ulcers. Swallowing disorders did not differ on the basis of primary or secondary SS. Swallowing disorders and specific swallowing symptoms were uniquely associated with reduced quality of life. Among those with swallowing disorders, 42 % sought treatment, with approximately half reporting improvement. Patient-perceived swallowing disorders are relatively common in SS and increase with disease severity. Specific swallowing symptoms uniquely and significantly reduce swallow and health-related quality of life, indicating the need for increased identification and management of dysphagia in this population.