目的:缺乏收缩力被认为是一种蠕动障碍。关于病因和临床特征的文献很少,关于与这种食管疾病相关的全身性疾病的证据有限。因此,我们的目的是使用最近文献中描述的临床算法来确定我们人群中收缩性缺失的病因.
方法:我们进行了回顾性研究,在2018年5月至2020年2月期间,在一家三级医院对所有被诊断为收缩性缺失的患者进行了描述性研究.关于人口特征的数据,药物,合并症,从临床记录中记录实验室和临床旁检查。
结果:共纳入72例收缩力缺失患者进行分析。女性占主导地位(n=43,59.7%),平均年龄55.4(±15.0)岁。我们在64例(88.9%)患者中发现了与收缩力缺失相关的全身性疾病。从这些,31例(43.1%)患者被诊断为全身性自身免疫性疾病,26例(36.1%)患者被认为因病理暴露于酸反流而缺乏收缩力,15例(20.8%)患者被诊断为其他非自身免疫性系统性疾病。其余8名(11.1%)患者中,没有潜在的系统性疾病可以证明诊断为收缩功能缺失.
结论:有必要采用系统的方法来寻找被诊断为收缩力缺失的患者的根本原因。高达90%的缺乏收缩性的患者具有与该病症相关的全身性病症。
OBJECTIVE: Absent contractility is considered a disorder of peristalsis. The literature about the etiology and clinical characteristics is scarce and the evidence on systemic diseases associated with this esophageal disorder is limited. Therefore, we aimed to determine the etiology of absent contractility in our population using the clinical algorithm recently described in the literature.
METHODS: We conducted a retrospective, descriptive study at a single tertiary hospital of all patients diagnosed of absent contractility between May 2018 and February 2020. Data on demographic characteristics, medication, comorbidities, and laboratory and paraclinical tests were recorded from clinical records.
RESULTS: A total of 72 patients with absent contractility were included for analysis. There was a predominance of female sex (n=43, 59.7%), with a mean age of 55.4 (±15.0) years. We identified a systemic disorder associated with absent contractility in 64 (88.9%) patients. From these, 31 (43.1%) patients were diagnosed with a systemic autoimmune disease, 26 (36.1%) patients were considered to have absent contractility secondary to pathological exposure to acid-reflux and 15 (20.8%) patients were diagnosed with other non-autoimmune systemic disorders. In the remaining eight (11.1%) patients, there were no underlying systemic disorders that could justify the diagnosis of absent contractility.
CONCLUSIONS: A systematic approach to search for an underlying cause in patients diagnosed with absent contractility is warranted. Up to 90% of patients with absent contractility have a systemic disorder associated with this condition.