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Gastroenterologie
a hepatologie

Gastroenterology and Hepatology

Gastroent Hepatol 2020; 74(4): 285–294. doi:10.14735/amgh2020285.

Elektrogastrografie u systémové sklerodermie – pilotní studie

Helena Medková1, Alice Jansová1, Tomáš Soukup Orcid.org  1, Darina Kohoutová2, Marcela Janebová1, Veronika Knoblochová1, Eva Peterová2, Blanka Kupková1, Ilja Tachecí Orcid.org  1, Jan Bureš Orcid.org  1

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Souhrn

Úvod:
Systémová sklerodermie (SSc – systemic sclerosis) je autoimunitní onemocnění s chronickým progresivním průběhem. Patogeneze SSc je charakterizována zánětem, vaskulopat a fibrózou. Mezi nejčastěji postižené orgány patří gastrointestinální trakt, a to až u 90 % nemocných. Klinické projevy jsou spojeny s dysmotilitou všech částí gastrointestinálního traktu, vč. žaludku. Elektrogastrografie (EGG) je neinvazivní metoda pro vyšetření žaludeční myoeletrické aktivity.

Cíl:
Cílem této prospektivní studie bylo podrobně posoudit EGG u SSc, vč. analýzy jednominutových intervalů a plochy amplitud.

Metoda:
Do studie bylo zařazeno 33 pacientů splňujících klasifikační kritéria SSc podle ACR/EULAR (5 mužů, 28 žen; průměrný věk 60 let). Pacienti byli rozděleni na klinické podskupiny: difúzní kožní forma SSc (dSSc) (n = 17), limitovaná kožní forma (lSSc) (n = 13) a ostatní (n = 3). Žaludeční myoelektrická aktivita byla vyšetřována pomocí EGG (MMS, Enschede, Nizozemsko).

Výsledky:
Celkem bylo vyhodnoceno 855 jednominutových intervalů EGG, u každého z nich byla hodnocena dominantní frekvence a posouzena plocha amplitud. Pouze jeden pacient měl plně normální EGG záznam. U většiny pacientů se EGG vyznačovala bradygastr (17 pacientů) nebo žaludeční arytm s převahou bradygastrie (6 pacientů). Postprandlní plocha amplitud se výrazně snížila ve srovnání s hodnotami nalačno. Poměr ploch amplitud po jídle: před jídlem byl ve všech intervalech nízký.

Závěr:
Bradygastrie a postprandlní snížení plochy amplitud byly nejcharakterističtějšími nálezy. Tyto změny byly obzvlášť vyjádřené u skupiny dSSc.

Klíčová slova

elektrogastrografie, systémová sklerodermie, žaludeční myoelektrická aktivita, dominantní frekvence, elektrogastrografická síla

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