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目的 :对结缔组织疾病患者进行食管运动功能研究 ,并对部分患者治疗前后的结果进行比较 ,以研究结缔组织疾病食管运动功能障碍的特点及其对治疗的反应。方法 :结缔组织疾病患者 2 9例 (类风湿性关节炎 7例 ,SLE 8例 ,硬皮病 7例 ,皮肌炎 2例 ,SLE合并硬皮病 2例 ,SLE合并皮肌炎 3例 )。其中食管症状组 15例 ,非食管症状组 14例。10例有食管症状的患者在确诊后进行激素或 /和免疫抑制剂的治疗 (疗程 3月 ) ,治疗后 3月再次重复食管测压。并与健康对照组 2 9例进行各项指标的比较。结果 :( 1)结缔组织疾病患者食管测压结果 :病例组远端食管蠕动压 (PA)、传导时间 (PD)、传导速度 (PV)与健康组相比有显著性差异 (P <0 0 5 ,P <0 0 1)。 ( 2 )食管症状组下食管括约肌压力 (LESP)、松弛率 (LESR)、PA、PD、PV与健康组和非食管症状组相比有显著性差异 (P <0 0 5 ,P <0 0 1)。 ( 3 )治疗后LESP、LESR、PA提高 ,以PA改变尤为明显。 ( 4 )治疗前后食管异常收缩波的百分比 :治疗前同步收缩的百分比为 2 1 4% ,治疗后为 1 1% (P <0 0 0 1)。结论 :本组结缔组织疾病出现食管运动功能障碍 ,有食管症状组较非食管症状组食管受累更为明显 ,治疗后随病情好转食管运动功能障碍得到改善。
OBJECTIVE: To study esophageal motility in patients with connective tissue disease and to compare the results of some patients before and after treatment to study the characteristics of esophageal motility dysfunction in connective tissue disease and its response to treatment. Methods: Twenty-nine patients with connective tissue diseases (7 cases of rheumatoid arthritis, 8 cases of SLE, 7 cases of scleroderma, 2 cases of dermatomyositis, 2 cases of SLE combined with scleroderma and 3 cases of SLE complicated with dermatomyositis) . Among them, 15 cases were esophageal symptoms and 14 cases were non-esophageal symptoms. Ten patients with esophageal symptoms were treated with hormones and / or immunosuppressants (at 3 months) after diagnosis, and esophageal manometry was repeated again 3 months after treatment. And compared with 29 healthy control subjects for each index. Results: (1) Esophageal manometry in patients with connective tissue diseases: There were significant differences in distal esophageal peristaltic pressure (PA), conduction time (PD), and conduction velocity (PV) between the two groups (P <0 0 5, P <0 0 1). (2) LESP, LESR, PA, PD and PV in esophageal symptom group were significantly different from those in healthy group and non-esophageal symptom group (P <0.05, P <0 0 1). (3) After treatment, LESP, LESR, PA increased to PA changes particularly evident. (4) The percentage of esophageal abnormal contraction wave before and after treatment: the percentage of systolic contraction before treatment was 21.4% and after treatment was 11% (P <0.01). Conclusion: Esophageal motility dysfunction is found in the connective tissue diseases of this group. Esophageal symptom group has more esophageal involvement than non-esophageal symptom group. After treatment, esophageal motility dysfunction improved with the improvement of disease.