硬皮病消化系统累及的评估和治疗.pdfVIP

硬皮病消化系统累及的评估和治疗 薛愉 1,2* 刘磊 1,2 于一云 1,2 杨雪 1,2 梁敏锐 1,2 宣丹旦 1,2 孔宁 1,2 郑舒聪 1,2 朱小霞 1,2 万伟国 1,2 邹和建 1,2 （1. 复旦大学附属华山医院风湿科 上海 200040 ；2. 复旦大学风湿、免疫、过敏性疾病研究中心 上海 200040） 摘 要 消化系统是系统性硬化症除皮肤外最常见的受累器官，从口腔到直肠肛门均可受累，范围非常广泛。系统 性硬化症患者消化系统受累症状不一，但消化系统受累的危害却不容小觑，症状明显者严重影响患者的生存质量。本文 对硬皮病消化系统受累的临床表现，评估方法和治疗进行详细综述，以帮助风湿科、消化科或其他科室医生能早期识别 硬皮病消化道受累的表现，能够让患者早诊断、早治疗，改善生存质量。 关键词 硬皮病 消化系统 胃食管反流 食管狭窄 Barrett 食管炎 食管腺癌 胃窦血管扩张症 小肠细菌过 度生长 假性肠梗阻 腹泻 便秘 R593.25 A 1006-1533(2017)S1-0045-07 中图分类号 ： 文献标识码 ： 文章编号 ： The evaluation and treatment of digestive system involvement in systemic sclerosis XUE Yu1,2*, LIU Lei1,2, YU Yiyun1,2, YANG Xue1,2, LIANG Minrui1,2, XUAN Dandan1,2, KONG Ning1,2, ZHENG Shucong1,2, ZHU Xiaoxia1,2, WAN Weiguo1,2, ZOU Hejian1,2 (1. Department of Rheumatism, Huashan Hospital, Fudan University, Shanghai 200040, China; 2. Institute of Rheumatology, Immunology and Allergy, Fudan University, Shanghai 200040, China) ABSTRACT Gastrointestinal (GI) system is the most common organ involved in systemic sclerosis (SSc) besides the skin. Virtually all parts of the GI tract can be involved. The GI involvement is quite heterogeneous and varying from asymptomatic disease to significant dysmotility. These symptoms are generally mild during the early stage of the disease and are likely ignored by physicians. Supportive and symptomatic treatment is the main therapeutic strategy though an early diagnosis is critical to successful management. This review focuses on the manifestation, diagnosis and management of GI involvement in SSc. KEY WORDS scleroderma; gastrointestinal tract; GERD; barrett oesophagus;