| 王慧芬,江薇,朱慧婷,等.有食管症状的特发性肌炎患者食管动力与肌酶谱及疾病评分的相关性分析[J].中国临床保健杂志,2025,28(3):368-371. |
| 有食管症状的特发性肌炎患者食管动力与肌酶谱及疾病评分的相关性分析 |
| Correlation analysis of esophageal motility,muscle enzyme spectrum,and disease score in patients with idiopathic myositis with esophageal symptoms |
| 投稿时间：2025-03-16 |
| DOI：10.3969/J.issn.1672-6790.2025.03.017 |
| 中文关键词: 特发性肌炎 体征和症状,消化系统 胃食管反流 吞咽障碍 |
| 英文关键词: Idiopathic inflammatory myositis Signs and symptoms,digestive Gastroesophageal reflux Deglutition disorders 〖FL |
| 基金项目:国家外国专家项目(G2022065007L) |
| 作者 | 单位 | E-mail | | 王慧芬 | 中日友好医院, 消化科,北京 100029 | wanghuifen2000@163.com | | 江薇 | 中日友好医院,风湿免疫科,北京 100029 | | | 朱慧婷 | 中日友好医院, 消化科,北京 100029 | | | 肖欣悦 | 中日友好医院,风湿免疫科,北京 100029 | | | 王淼 | 中日友好医院, 消化科,北京 100029 | | | 张艳丽 | 中日友好医院, 消化科,北京 100029 | 13521234067@163.com |
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| 中文摘要: |
| 目的 研究具有食管症状(吞咽困难、反流或烧心)的特发性肌炎(IIM)患者食管动力学,分析食管动力与肌酶谱、疾病临床活动程度之间的相关性。方法 选取2023年6月至2024年6月在中日友好医院确诊为IIM并有食管症状(吞咽困难、反流或烧心)的15例患者为IIM组,同期诊断为胃食管反流病(GERD)且无免疫系统疾病的15例患者为GERD组。比较2组患者的一般资料、食管动力学相关指标,分析IIM患者的疾病评分与食管压力指标之间的相关性。结果 IIM组中只有吞咽困难症状的患者9例,既有吞咽困难又有反流的患者6例,肌酶谱升高的患者7例,肌酶谱正常的患者8例,患者的疾病总体活动度为(6.50±2.43)分,8个肌群徒手肌力试验为(63.87±17.41)分。所有IIM患者均进行胃镜检查,根据反流性食管炎的洛杉矶分级,正常食管黏膜、A级、B级患者分别为7例(46.67%)、7例(46.67%)、1例(6.67%)。IIM组的上食管括约肌静息压及上食管括约肌残余压均低于GERD组(均P <0.05),IIM组的食管体部蠕动性收缩比例低于GERD组(P=0.021),IIM组的食管体部无效收缩比例高于GERD组(P=0.037)。IIM患者的肌酸激酶(CK)值与食管症状呈负相关(P=0.039)。结论 有食管症状的IIM患者存在上食管括约肌功能障碍、食管体部蠕动功能障碍；CK值越高,患者越容易表现为仅有吞咽困难的症状。 |
| 英文摘要: |
| Objective To study the clinical data and esophageal motility characteristics of idiopathic myositis (IIM) patients with esophageal symptoms (dysphagia,reflux,or heartburn),and analyze the correlation between esophageal motility,muscle enzyme spectrum,and clinical activity of the disease.Methods Fifteen patients diagnosed as IIM with esophageal symptoms (dysphagia,reflux or heartburn) in China-Japan Friendship Hospital from June 2023 to June 2024 were selected as IIM group,and 15 patients diagnosed as gastroesophageal reflux disease (GERD) without immune system diseases at the same time were selected as GERD group.The general information and esophageal motility related indicators were compared between two groups,and the correlation between disease scores and esophageal pressure measurement indicators in IIM patients was analyzed.Result In the IIM group,there were a total of 9 patients with only swallowing difficulties,6 patients with both swallowing difficulties and reflux,7 patients with elevated muscle enzyme spectra,and 8 patients with normal muscle enzyme spectra.The overall disease activity of the included patients was (6.50±2.43)points,and the manual muscle testing (MMT8) was (63.87±17.41)points.All included IIM patients underwent gastroscopy examination.According to the Los Angeles classification of reflux esophagitis,there were 7 cases (46.67%) of normal esophageal mucosa,7 cases (46.67%) of grade A,and 1 case (6.67%) of grade B patients,respectively.The resting pressure and residual pressure of the upper esophageal sphincter in the IIM group were significantly lower than those in the GERD group (P<0.05).The proportion of peristaltic contractions of the esophageal body in the IIM group was significantly lower than that in the GERD group (P=0.021),and the proportion of ineffective contractions of the esophageal body in the IIM group was significantly higher than that in the GERD group (P=0.037).The CK value of IIM patients is negatively correlated with esophageal symptoms (P=0.039).Conclusions IIM patients with combined esophageal symptoms exhibit dysfunction of the upper esophageal sphincter and esophageal peristalsis;the higher the CK value,the more likely the patient′s esophageal symptoms are to manifest as swallowing difficulties alone. |
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