結締組織疾病的食道運動性－－測壓器研究的初步報告

Esophageal Motility of Connective Tissue Diseases-- a Preliminary Report of Manometry Study

吾人研究54位結締組織疾病病人的食道運動性。包括20位全身性紅斑性狼瘡，18位類風濕性關節炎，8位進行性全身性鞏皮病，5位多肌炎及3位原發性薛格連氏症候群接受食道測壓器研究。所有病人做測壓器研究之前均須禁食及禁藥8小時以上，且病人均沒使用類固醇製劑至少三個月以上。另外以15位健康正常人做對照組。結果發現有鞏皮病的病人，在統計上較其他病人及正常人有顯著低的測壓計檢查變數，包括尖峰壓力，所有食道體的收縮時間及遠端食道體傳導速度。運動波的分析顯示所有病人均有異常的蠕動波。此外，多肌炎及鞏皮病的病人有較其他病人更多的非蠕動波。吾人總結研究報告認為對偵測結締組織病人的食道病變，測壓計是一種敏感性及特異性均高的檢查。

A total of 54 patients with connective tissue diseases were studied for esophageal motility. There were 20 cases of systemic lupus erythematosus, 18 cases of rheumatoid arthritis, 8 cases of progressive systemic sclerosis, 5 cases of polymyositis and 3 cases of Sjögren syndrome. Manometry examinations were performed with all the medications and food withdraw for at least 8 hours. Another 15 healthy persons were served as a control group. Patients with scleroderma had statistically significant lower parameters than other patients and control persons. These included peak, mean and expiration pressures of lower sphincter, distal body peak pressure, all three portions of esophageal body contraction time, and distal body propagation speed. Motility waves analyses showed abnormal peristaltic waves in all groups of connective tissue diseases. Patients with scleroderma and polymyositis had higher non-propagating waves than other gorups of patients. In conclusion, manometry is a sensitive and specific examination to denote esophageal dysfunction in patients with connective tissue diseases.