在日本,系统性硬化症患者中,药物耐药性逆流性食道炎的患病率和危险因素
Shiko Kuribayashi1, Fumihiko Nakamura2, Sei-Ichiro Motegi3
1Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, 3-39-15 Showa-Machi Maebashi, Gunma, 371-8511, Japan. shikokuri@gunma-u.ac.jp.
Journal of gastroenterology
|January 22, 2024
概括
系统性硬化症患者通常会患上抗药性反流性食道炎. 缺少收缩性和食道胃结合功能不佳是关键的危险因素,需要更强烈的酸抑制治疗.
科学领域:
- 胃肠病学 胃肠病学
- 类风湿病学 类风湿病学
- 临床医学 临床医学
背景情况:
- 系统性硬化症 (SSc) 经常导致食道动力障碍和食道胃结 (EGJ) 屏障功能受损.
- 这通常会导致抗质子抑制剂 (PPI) 耐火性反流性食道炎 (RE).
- 了解SSc中的RE管理和耐火病例至关重要.
研究的目的:
- 调查日本SSc患者目前的反流食道炎 (RE) 管理方法.
- 为了确定这一群体中药物耐药性RE的患病率和风险因素.
主要方法:
- 188名SSc患者的回顾性审查,这些患者接受了食道高分辨率计量 (HRM) 和食道胃二透镜 (EGD).
- 评估RE,胃食道门 (GEFV) 等级和食道运动 (芝加哥分类v3.0).
- 药物耐药性RE定义为尽管存在标准PPI或任何诺普拉赞 (VPZ) 剂量,但存在RE.
主要成果:
- 药物耐药性RE在16.0%的患者中被发现 (30/188).
- 耐火性RE的重要危险因素包括EGD的数量和缺少食道收缩性.
- 合并的缺乏收缩性和GEFV等级III/IV显著增加了RE风险.
结论:
- 患有持续反流症状和GEFVIII/IV级缺乏收缩性的患者需要强烈的酸性抑制.
- 建议通过强烈的酸抑制进行主动管理,以防止SSc.中的药物耐药RE.
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