Relationship Between Gastrointestinal Transit, Medsger Gastrointestinal Severity, and University of California-Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 Symptoms in Patients With Systemic Sclerosis.
Relationship Between Gastrointestinal Transit, Medsger Gastrointestinal Severity, and University of California-Los Angeles Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 Symptoms in Patients With Systemic Sclerosis.
复制标题
DOI：
10.1002/acr.24488
复制
发表时间：
2022-03
影响因子：
4.7
通讯作者：
Wigley FM
中科院分区：
文献类型：
--
作者：
McMahan ZH;Tucker AE;Perin J;Volkmann ER;Kulkarni S;Ziessman HA;Pasricha PJ;Wigley FM
硬皮病（SSc）相关胃肠道（GI）并发症可归因于多种因素，包括饮食、微生物群生态失调或GI转运异常。我们研究了异常GI转运对SSc Medsger GI严重程度评分和/或UCLA GIT 2.0症状的贡献。患有SSc和GI症状的患者（n=71）和健康对照组（n=18）接受了全肠传输（WGT）造影，以评估从食管到结肠的传输。测量每个GI区域中延迟传输和排空百分比的存在。我们比较了Medsger GI严重程度评分（0-4）类别之间以及UCLA GIT 2.0领域和总分（0-3）之间的WGT测量值。80%的患者在WGT造影上有>1个肠道异常区域。所有需要全胃肠外营养的患者小肠转运延迟，而其他Medsger GI严重程度组中仅约11%的患者发生小肠转运延迟（p=<0.01）。与其他Medsger GI组相比，Medsger GI评分为3分（假性梗阻和/或吸收不良）的患者更可能发生重度结肠传输延迟（p=0.02）。72小时时，70%的患者结肠排空≤30%。GERD症状与延迟食管（r=-0.31，p =0.05）和胃排空（r=-0.32，p =0.05）之间存在中度相关性。这些数据在提供证据证明SSc肠病影响GI内容物的转运以及转运延迟部分解释肠道症状和Medsger GI严重程度方面很重要。需要进行前瞻性研究，检查针对严重GI并发症高危患者的GI转运异常进行早期治疗干预的获益。
Scleroderma (SSc)-associated gastrointestinal (GI) complications are attributed to a variety of factors including diet, microbiota dysbiosis, or GI transit abnormalities. We examined the contribution of abnormal GI transit to SSc Medsger GI severity scores and/or UCLA GIT 2.0 symptoms. Patients with SSc and GI symptoms (n=71) and healthy controls (n=18) underwent whole gut transit (WGT) scintigraphy to assess transit from the esophagus to the colon. The presence of delayed transit and percent emptying in each GI region were measured. We compared the WGT measurements between categories of the Medsger GI severity score (0–4) and across UCLA GIT 2.0 domains and total score (0–3). Eighty-percent of patients had >1 abnormal region of the gut on WGT scintigraphy. All patients requiring total parenteral nutrition had delayed small bowel transit, compared to only ~11% of patients in other Medsger GI severity groups (p=<0.01). Severe colonic transit delays were more likely in patients with Medsger GI scores of 3 (pseudo-obstruction and/or malabsorption) compared to other Medsger GI groups (p=0.02). Seventy-percent of these patients had ≤30% colonic emptying at 72 hours. Modest associations were noted between GERD symptoms and delayed esophageal (r=−0.31,p=0.05) and gastric emptying (r=−0.32,p=0.05). These data are important in providing evidence that SSc bowel disease affects transit of GI content and that delay in transit accounts in part for both bowel symptoms and Medsger GI severity. Prospective studies examining the benefit of early therapeutic intervention targeting GI transit abnormalities in patients at high-risk for severe GI complications are needed.
登录
查看更多内容
影响因子：
1.4
作者：
Błochowiak K;Olewicz-Gawlik A;Polańska A;Nowak-Gabryel M;Kocięcki J;Witmanowski H;Sokalski J
通讯作者：
Sokalski J
影响因子：
13.3
作者：
Patterson, K. A.;Roberts-Thomson, P. J.;Walker, J. G.
通讯作者：
Walker, J. G.
影响因子：
3.1
作者：
Camilleri M;Piessevaux H;Yiannakou Y;Tack J;Kerstens R;Quigley EMM;Ke M;Da Silva S;Levine A
通讯作者：
Levine A
影响因子：
4.9
作者：
Odunsi ST;Camilleri M
通讯作者：
Camilleri M
影响因子：
10.6
作者：
Solnes, Lilja B.;Sheikhbahaei, Sara;Ziessman, Harvey A.
通讯作者：
Ziessman, Harvey A.