摘要: |
约90%的硬皮病患者可出现不同程度的消化系统受累,其发病机制可能与胶原蛋白沉积、自身抗体作用、平滑肌细胞炎症及萎缩、特征性纤维化等有关。消化系统受累的常见临床表现多样,主要包括胃食管反流病、Barrett食管、胃轻瘫、假性肠梗阻、小肠细菌过度生长、便秘等。早期诊断和治疗对改善预后尤为关键。因此,本文就硬皮病消化系统受累临床诊治的最新进展作一综述,以期提高其诊治水平。 |
关键词: 硬皮病 消化系统 胃食管反流病 Barrett食管 假性肠梗阻 小肠细菌过度生长 营养不良 |
DOI:10.12025/j.issn.1008-6358.2016.20160742 |
分类号: |
基金项目: |
|
Manifestations and Management Progress of Gastrointestinal Involvement in Scleroderma |
xu wei and Zhang Miao Jia
|
Wuxi People’s Hospital Affiliated to Nanjing Medical University,Jiangsu Province Hospital Affiliated to Nanjing Medical University
|
Abstract: |
It is estimated that approximately 90% of patients with scleroderma have gastrointestinal tract involvement. The pathophysiology may due to collagen deposition, autoantibodies, smooth muscle cell inflammation and atrophy, and the characteristic fibrosis. Major manifestations include gastroesophageal reflux disease(GERD), Barrett’s esophagus, gastroparesis, intestinal pseudo-obstruction, small intestinal bacterial overgrowth(SIBO), and constipation. Early recognition and treatment are important. Patients with scleroderma should receive proton pump inhibitors(PPI) treatment to prevent GER complications, and also possibly to prevent or slow the progression of interstitial lung disease(ILD). Prokinetics are more effective in the early stages of the disease. More and more research demonstrated the benefits of antibiotic therapy for gastrointestinal complications. Mortality due to significant malnutrition has been estimated to be 20%. |
Key words: Scleroderma Gastrointestinal tract Gastroesophageal reflux disease(GERD) Barrett’s esophagus Intestinal pseudo-obstruction Small intestinal bacterial overgrowth(SIBO) |