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Взаимосвязь гастроэзофагеальной рефлюксной болезни и интерстициального поражения легких при системной склеродермии
Взаимосвязь гастроэзофагеальной рефлюксной болезни и интерстициального поражения легких при системной склеродермии
Сосновская А.В., Фомин В.В., Лебедева М.В. и др. Взаимосвязь гастроэзофагеальной рефлюксной болезни и интерстициального поражения легких при системной склеродермии. Consilium Medicum. 2015; 17 (12): 73–76. DOI:10.26442/2075-1753_2015.12.73-76
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Аннотация
Системная склеродермия – это системное аутоиммунное заболевание соединительной ткани с поражением кожи и вовлечением различных органов. Гастроэзофагеальная рефлюксная болезнь (ГЭРБ) является частым клиническим проявлением системной склеродермии, так же как и интерстициальное поражение легких, одна из ведущих причин смертности при системной склеродермии. Во многих исследованиях изучалось возможное влияние ГЭРБ на прогрессирование поражения легких в результате микроаспирации желудочного содержимого, ведущей к развитию воспаления и последующего фиброза. Цель этого обзора – описать данные о возможной взаимосвязи между ГЭРБ и интерстициальным поражением легких и подчеркнуть необходимость ранней диагностики и начала лечения с целью замедления прогрессирования интерстициального поражения легких при системной склеродермии.
Ключевые слова: системная склеродермия, гастроэзофагеальная рефлюксная болезнь, интерстициальное поражение легких.
Ключевые слова: системная склеродермия, гастроэзофагеальная рефлюксная болезнь, интерстициальное поражение легких.
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Systemic sclerosis (SSc) is a rare autoimmune connective tissue disease characterized by thickening of the skin and multiple organ involvement. Gastroesophageal reflux disease (GERD) is a common disease manifestation of SSc, as well as interstitial lung disease (ILD), the latter is the main cause of SSc related mortality. Several studies broached the issue of a potential association of GERD with SSc-ILD and indicated that microaspiration of gastric acid may cause inflammation consecutively leading to lung fibrosis. The aim of this review is to recapitulate current evidence for a link between GERD and ILD in SSc patients and emphasize the necessity of early diagnosis and treatment in order to hopefully slow down the progression of mortality driving SSc-ILD.
Key words: systemic sclerosis, gastroesophageal reflux disease, interstitial lung disease.
Key words: systemic sclerosis, gastroesophageal reflux disease, interstitial lung disease.
Полный текст
Список литературы
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25. Ioannidis JP, Vlachoyiannopoulos PG, Haidich AB et al. Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 2005; 118: 2–10.
26. Jaffin BW, Chang P, Spiera H. Fecal incontinence inscleroderma. Clinical features, anorectal manometric findings, and their therapeutic implications. J Clin Gastroenterol 1997; 25: 513–7.
27. Kaloudi О, Miniati I, Alari S. Interstitial lung disease in systemic sclerosis. Intern Emerg Med 2007; 2 (4): 250–5.
28. Kay L, Jorgensen T, Jensen KH. The epidemiology ofirritable bowel syndrome in a random population: prevalence, incidence, natural history and risk factors. J Intern Med 1994; 236: 23–30.
29. Khanna D, Clements PJ, Furst DE, Tashkin DP. Current concepts in disease-modifying therapy for systemic sclerosis-associated interstitial lung disease: lessons from clinical trials. Curr Rheumatol Rep 2009; 11: 111–9.
30. Khanna D, Hays RD, Park GS et al. Development of a preliminary scleroderma gastrointestinal tract 1.0 Quality of Life Instrument. Arthritis Rheum 2007; 57: 1280–6.
31. Kim DS, Yoo В, Lee JS et al. The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia. Sarcoidosis Vase Diffuse Lung Dis 2002; 19 (2): 121–7.
32. Lahcene M, Oumnia N, Matougui N et al. Esophageal dysmotility is scleroderma: a prospective study of 183 cases. Gastroenterol Clin Biol 2009; 33: 466–9.
33. Marcisz C, Kucharz EJ, Brzezinska-Wcislo L et al. Pulmonary functional abnormalities in asymptomatic patients with systemic sclerosis. Eur J Intern Med 2003; 14 (3): 162–5.
34. Marie I, Dominique S, Levesque H et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthritis Rheum 2001; 45: 346–54.
35. McNearney TA, Reveille JD, Fischbach M et al. Pulmonary involvement in systemic sclerosis: associations with genetic, serologic, sociodemographic, and behavioral factors. Arthr Rheum 2007; 57 (2): 318–26.
36. Morgan С, Knight С, Lunt M et al. Predictors of end stage lung disease in a cohort of patients with scleroderma. Ann Rheum Dis 2003; 62 (2): 146–50.
37. Nishimagi E, Tochimoto A, Kawaguchi Y et al. Characteristics of patients with early systemic sclerosis and severe gastrointestinal tract involvement. J Rheumatol 2007; 34: 2050–5.
38. Nora M Thoua et al. Assessment of gastrointestinal symptoms in patients with systemic sclerosis in a UK tertiary referral centre. Rheumatology (Oxford) 2010.
39. Parra ER, Otani LH, de Carvalho EF et al. Systemic sclerosis and idiopathic interstitial pneumonia: histomorphometric differences in lung biopsies. J Bras Pneumol 2009; 35 (6): 529–40.
40. Peters-Golden M, Wise RA, Schneider P et al. Clinical and demographic predictors of loss of pulmonary function in systemic sclerosis. Medicine Baltimore 1984; 63 (4): 221–31.
41. Remy-Jardin M, Remy J, Wallaert B. Pulmonary involvement in progressive systemic sclerosis sequential evaluation with CT, pulmonary tests and broncho-alveolar lavage. Radiology 1993; 188: 499–506.
42. Ruangjutipopan S, Kasitanon N, Louthrenoo W et al. Causes of death and poor survival prognostic factors in thai patients with systemic sclerosis. J Med Assoc Thai 2002; 85 (11): 1204–9.
43. Sallam H, McNearney TA, Chen JD. Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma). Aliment Pharmacol Ther 2006; 23: 691–712.
44. Savarino E, Bazzica M, Zentilin P et al. Gastroesophagealreflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring. Am J Respir Crit Care Med 2009; 179: 408–13.
45. Schurawitzki H, Stiglbauer R, Graninger W et al. Interstitial lung disease in progressive systemic sclerosis: high-resolution CT versus radiography. Radiology 1990; 176 (3): 755–9.
2. Kogan E.A., Korenev B.M., Popova E.N. i dr. Interstitsial'nye bolezni legkikh. M.: Litterra, 2007; s. 186–91. [in Russian]
3. Anan'eva L.P., Teplova L.V., Lesniak V.N. i dr. Klinicheskaia otsenka proiavlenii interstitsial'nogo porazheniia legkikh pri sistemnoi sklerodermii po dannym komp'iuternoi tomografii vysokogo razresheniia. Nauch.-prakt. revmatologiia. 2011; 2: 30–9. [in Russian]
4. Guseva N.G. Sistemnaia sklerodermiia: klinika, diagnostika, lechenie. Ros. zhurn. kozhnykh i venericheskikh boleznei. 2002; 4: 5–15. [in Russian]
5. Nasonova V.A., Astapenko M.G. Klinicheskaia revmatologiia. M.: Meditsina, 1989; s. 175–93. [in Russian]
6. Chuchalin A.G. Klinicheskie rekomendatsii. Pul'monologiia. M.: GEOTAR-Media, 2007; s. 1–37. [in Russian]
7. Grippi M.A. Patofiziologiia legkikh. M.: Binom, 2005; s. 130–41. [in Russian]
8. Bassotti G, Battaglia E, Debernardi V et al. Esophageal dysfunction in scleroderma: relationship with disease subsets. Arthritis Rheum 1997; 40: 2252–9.
9. Bouros D, Wells AU, Nicholson AG et al. Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 2002; 165 (12): 1581–6.
10. Christmann RB, Wells AU, Capelozzi VL, Silver RM. Gastroesophageal reflux incites interstitial lung disease in systemic sclerosis: clinical, radiologic, histopathologic, and treatment evidence.
11. Clements P, Goldin J, Kleerup E et al. Regional differences in bronchoalveolar lavage and thoracic high-resolution computed tomography results in dyspno patients with systemic sclerosis. Arthr Rheum 2004; 50: 1909–17.
12. De Souza RB, Borges CT, Capelozzi VL et al. Centrilobular fibrosis: an underrecognized pattern in systemic sclerosis. Respiration 2009; 77 (4): 389–97.
13. Desai SR, Veeraraghavan S, Hansell DM et al. CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology 2004; 232 (2): 560–7.
14. Downing TE, Sporn TA, Bollinger RR et al. Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity. Exp Biol Med (Maywood) 2008; 1202–12.
15. Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol 2006; 40: 769–75.
16. Ebert EC. Gastric and enteric involvement in progressive systemic sclerosis. J Clin Gastroenterol 2008; 42: 5–12.
17. Geirsson AJ, Wollheim FA, Akesson A. Disease severity of 100 patients with systemic sclerosis over a period of 14 years: using a modified Medsger scale. Ann Rheum Dis 2001; 60 (12): 1117–22.
18. Gilson M, Zerkak D, Wipff J et al. Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases. Eur Respir J 2010; 35 (1): 112–7.
19. Goh NS, Desai SR, Veeraraghavan S et al. Interstitial lung disease in systemic sclerosis: a simple staging system. Am J Respir Crit Care Med 2008; 177 (11): 1248–54.
20. Goldin JG, Lynch DA, Strollo DC et al. High-resolution CT scan findings in patients with symptomatic scleroderma-related interstitial lung disease. Chest 2008; 134 (2): 358–67.
21. Greenwald GI, Tashkin DP, Gong H et al. Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study. Am J Med 1987; 83 (1): 83–92.
22. Guttadauria M, Ellman H, Emmanuel G et al. Pulmonary function in scleroderma. Arthritis Rheum 1977; 20: 1071–9.
23. Harrison NK, Myers AR, Corrin B et al. Structural features of interstitial lung disease in systemic sclerosis. Am Rev Respir Dis 1991; 144 (3 Pt 1): 706–13.
24. Highland KB, Silver RM. Clinical aspects of lung involvement: lessons from idiopathic pulmonary fibrosis and the scleroderma lung study. Curr Rheumatol 2005; 7 (2): 135–41.
25. Ioannidis JP, Vlachoyiannopoulos PG, Haidich AB et al. Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 2005; 118: 2–10.
26. Jaffin BW, Chang P, Spiera H. Fecal incontinence inscleroderma. Clinical features, anorectal manometric findings, and their therapeutic implications. J Clin Gastroenterol 1997; 25: 513–7.
27. Kaloudi О, Miniati I, Alari S. Interstitial lung disease in systemic sclerosis. Intern Emerg Med 2007; 2 (4): 250–5.
28. Kay L, Jorgensen T, Jensen KH. The epidemiology ofirritable bowel syndrome in a random population: prevalence, incidence, natural history and risk factors. J Intern Med 1994; 236: 23–30.
29. Khanna D, Clements PJ, Furst DE, Tashkin DP. Current concepts in disease-modifying therapy for systemic sclerosis-associated interstitial lung disease: lessons from clinical trials. Curr Rheumatol Rep 2009; 11: 111–9.
30. Khanna D, Hays RD, Park GS et al. Development of a preliminary scleroderma gastrointestinal tract 1.0 Quality of Life Instrument. Arthritis Rheum 2007; 57: 1280–6.
31. Kim DS, Yoo В, Lee JS et al. The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia. Sarcoidosis Vase Diffuse Lung Dis 2002; 19 (2): 121–7.
32. Lahcene M, Oumnia N, Matougui N et al. Esophageal dysmotility is scleroderma: a prospective study of 183 cases. Gastroenterol Clin Biol 2009; 33: 466–9.
33. Marcisz C, Kucharz EJ, Brzezinska-Wcislo L et al. Pulmonary functional abnormalities in asymptomatic patients with systemic sclerosis. Eur J Intern Med 2003; 14 (3): 162–5.
34. Marie I, Dominique S, Levesque H et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthritis Rheum 2001; 45: 346–54.
35. McNearney TA, Reveille JD, Fischbach M et al. Pulmonary involvement in systemic sclerosis: associations with genetic, serologic, sociodemographic, and behavioral factors. Arthr Rheum 2007; 57 (2): 318–26.
36. Morgan С, Knight С, Lunt M et al. Predictors of end stage lung disease in a cohort of patients with scleroderma. Ann Rheum Dis 2003; 62 (2): 146–50.
37. Nishimagi E, Tochimoto A, Kawaguchi Y et al. Characteristics of patients with early systemic sclerosis and severe gastrointestinal tract involvement. J Rheumatol 2007; 34: 2050–5.
38. Nora M Thoua et al. Assessment of gastrointestinal symptoms in patients with systemic sclerosis in a UK tertiary referral centre. Rheumatology (Oxford) 2010.
39. Parra ER, Otani LH, de Carvalho EF et al. Systemic sclerosis and idiopathic interstitial pneumonia: histomorphometric differences in lung biopsies. J Bras Pneumol 2009; 35 (6): 529–40.
40. Peters-Golden M, Wise RA, Schneider P et al. Clinical and demographic predictors of loss of pulmonary function in systemic sclerosis. Medicine Baltimore 1984; 63 (4): 221–31.
41. Remy-Jardin M, Remy J, Wallaert B. Pulmonary involvement in progressive systemic sclerosis sequential evaluation with CT, pulmonary tests and broncho-alveolar lavage. Radiology 1993; 188: 499–506.
42. Ruangjutipopan S, Kasitanon N, Louthrenoo W et al. Causes of death and poor survival prognostic factors in thai patients with systemic sclerosis. J Med Assoc Thai 2002; 85 (11): 1204–9.
43. Sallam H, McNearney TA, Chen JD. Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma). Aliment Pharmacol Ther 2006; 23: 691–712.
44. Savarino E, Bazzica M, Zentilin P et al. Gastroesophagealreflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring. Am J Respir Crit Care Med 2009; 179: 408–13.
45. Schurawitzki H, Stiglbauer R, Graninger W et al. Interstitial lung disease in progressive systemic sclerosis: high-resolution CT versus radiography. Radiology 1990; 176 (3): 755–9.
2. Коган Е.А., Коренев Б.М., Попова Е.Н. и др. Интерстициальные болезни легких. М.: Литтерра, 2007; с. 186–91. / Kogan E.A., Korenev B.M., Popova E.N. i dr. Interstitsial'nye bolezni legkikh. M.: Litterra, 2007; s. 186–91. [in Russian]
3. Ананьева Л.П., Теплова Л.В., Лесняк В.Н. и др. Клиническая оценка проявлений интерстициального поражения легких при системной склеродермии по данным компьютерной томографии высокого разрешения. Науч.-практ. ревматология. 2011; 2: 30–9. / Anan'eva L.P., Teplova L.V., Lesniak V.N. i dr. Klinicheskaia otsenka proiavlenii interstitsial'nogo porazheniia legkikh pri sistemnoi sklerodermii po dannym komp'iuternoi tomografii vysokogo razresheniia. Nauch.-prakt. revmatologiia. 2011; 2: 30–9. [in Russian]
4. Гусева Н.Г. Системная склеродермия: клиника, диагностика, лечение. Рос. журн. кожных и венерических болезней. 2002; 4: 5–15. / Guseva N.G. Sistemnaia sklerodermiia: klinika, diagnostika, lechenie. Ros. zhurn. kozhnykh i venericheskikh boleznei. 2002; 4: 5–15. [in Russian]
5. Насонова В.А., Астапенко М.Г. Клиническая ревматология. М.: Медицина, 1989; с. 175–93. / Nasonova V.A., Astapenko M.G. Klinicheskaia revmatologiia. M.: Meditsina, 1989; s. 175–93. [in Russian]
6. Чучалин А.Г. Клинические рекомендации. Пульмонология. М.: ГЭОТАР-Медиа, 2007; с. 1–37. / Chuchalin A.G. Klinicheskie rekomendatsii. Pul'monologiia. M.: GEOTAR-Media, 2007; s. 1–37. [in Russian]
7. Гриппи М.А. Патофизиология легких. М.: Бином, 2005; с. 130–41. / Grippi M.A. Patofiziologiia legkikh. M.: Binom, 2005; s. 130–41. [in Russian]
8. Bassotti G, Battaglia E, Debernardi V et al. Esophageal dysfunction in scleroderma: relationship with disease subsets. Arthritis Rheum 1997; 40: 2252–9.
9. Bouros D, Wells AU, Nicholson AG et al. Histopathologic subsets of fibrosing alveolitis in patients with systemic sclerosis and their relationship to outcome. Am J Respir Crit Care Med 2002; 165 (12): 1581–6.
10. Christmann RB, Wells AU, Capelozzi VL, Silver RM. Gastroesophageal reflux incites interstitial lung disease in systemic sclerosis: clinical, radiologic, histopathologic, and treatment evidence.
11. Clements P, Goldin J, Kleerup E et al. Regional differences in bronchoalveolar lavage and thoracic high-resolution computed tomography results in dyspno patients with systemic sclerosis. Arthr Rheum 2004; 50: 1909–17.
12. De Souza RB, Borges CT, Capelozzi VL et al. Centrilobular fibrosis: an underrecognized pattern in systemic sclerosis. Respiration 2009; 77 (4): 389–97.
13. Desai SR, Veeraraghavan S, Hansell DM et al. CT features of lung disease in patients with systemic sclerosis: comparison with idiopathic pulmonary fibrosis and nonspecific interstitial pneumonia. Radiology 2004; 232 (2): 560–7.
14. Downing TE, Sporn TA, Bollinger RR et al. Pulmonary histopathology in an experimental model of chronic aspiration is independent of acidity. Exp Biol Med (Maywood) 2008; 1202–12.
15. Ebert EC. Esophageal disease in scleroderma. J Clin Gastroenterol 2006; 40: 769–75.
16. Ebert EC. Gastric and enteric involvement in progressive systemic sclerosis. J Clin Gastroenterol 2008; 42: 5–12.
17. Geirsson AJ, Wollheim FA, Akesson A. Disease severity of 100 patients with systemic sclerosis over a period of 14 years: using a modified Medsger scale. Ann Rheum Dis 2001; 60 (12): 1117–22.
18. Gilson M, Zerkak D, Wipff J et al. Prognostic factors for lung function in systemic sclerosis: prospective study of 105 cases. Eur Respir J 2010; 35 (1): 112–7.
19. Goh NS, Desai SR, Veeraraghavan S et al. Interstitial lung disease in systemic sclerosis: a simple staging system. Am J Respir Crit Care Med 2008; 177 (11): 1248–54.
20. Goldin JG, Lynch DA, Strollo DC et al. High-resolution CT scan findings in patients with symptomatic scleroderma-related interstitial lung disease. Chest 2008; 134 (2): 358–67.
21. Greenwald GI, Tashkin DP, Gong H et al. Longitudinal changes in lung function and respiratory symptoms in progressive systemic sclerosis. Prospective study. Am J Med 1987; 83 (1): 83–92.
22. Guttadauria M, Ellman H, Emmanuel G et al. Pulmonary function in scleroderma. Arthritis Rheum 1977; 20: 1071–9.
23. Harrison NK, Myers AR, Corrin B et al. Structural features of interstitial lung disease in systemic sclerosis. Am Rev Respir Dis 1991; 144 (3 Pt 1): 706–13.
24. Highland KB, Silver RM. Clinical aspects of lung involvement: lessons from idiopathic pulmonary fibrosis and the scleroderma lung study. Curr Rheumatol 2005; 7 (2): 135–41.
25. Ioannidis JP, Vlachoyiannopoulos PG, Haidich AB et al. Mortality in systemic sclerosis: an international meta-analysis of individual patient data. Am J Med 2005; 118: 2–10.
26. Jaffin BW, Chang P, Spiera H. Fecal incontinence inscleroderma. Clinical features, anorectal manometric findings, and their therapeutic implications. J Clin Gastroenterol 1997; 25: 513–7.
27. Kaloudi О, Miniati I, Alari S. Interstitial lung disease in systemic sclerosis. Intern Emerg Med 2007; 2 (4): 250–5.
28. Kay L, Jorgensen T, Jensen KH. The epidemiology ofirritable bowel syndrome in a random population: prevalence, incidence, natural history and risk factors. J Intern Med 1994; 236: 23–30.
29. Khanna D, Clements PJ, Furst DE, Tashkin DP. Current concepts in disease-modifying therapy for systemic sclerosis-associated interstitial lung disease: lessons from clinical trials. Curr Rheumatol Rep 2009; 11: 111–9.
30. Khanna D, Hays RD, Park GS et al. Development of a preliminary scleroderma gastrointestinal tract 1.0 Quality of Life Instrument. Arthritis Rheum 2007; 57: 1280–6.
31. Kim DS, Yoo В, Lee JS et al. The major histopathologic pattern of pulmonary fibrosis in scleroderma is nonspecific interstitial pneumonia. Sarcoidosis Vase Diffuse Lung Dis 2002; 19 (2): 121–7.
32. Lahcene M, Oumnia N, Matougui N et al. Esophageal dysmotility is scleroderma: a prospective study of 183 cases. Gastroenterol Clin Biol 2009; 33: 466–9.
33. Marcisz C, Kucharz EJ, Brzezinska-Wcislo L et al. Pulmonary functional abnormalities in asymptomatic patients with systemic sclerosis. Eur J Intern Med 2003; 14 (3): 162–5.
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34. Marie I, Dominique S, Levesque H et al. Esophageal involvement and pulmonary manifestations in systemic sclerosis. Arthritis Rheum 2001; 45: 346–54.
35. McNearney TA, Reveille JD, Fischbach M et al. Pulmonary involvement in systemic sclerosis: associations with genetic, serologic, sociodemographic, and behavioral factors. Arthr Rheum 2007; 57 (2): 318–26.
36. Morgan С, Knight С, Lunt M et al. Predictors of end stage lung disease in a cohort of patients with scleroderma. Ann Rheum Dis 2003; 62 (2): 146–50.
37. Nishimagi E, Tochimoto A, Kawaguchi Y et al. Characteristics of patients with early systemic sclerosis and severe gastrointestinal tract involvement. J Rheumatol 2007; 34: 2050–5.
38. Nora M Thoua et al. Assessment of gastrointestinal symptoms in patients with systemic sclerosis in a UK tertiary referral centre. Rheumatology (Oxford) 2010.
39. Parra ER, Otani LH, de Carvalho EF et al. Systemic sclerosis and idiopathic interstitial pneumonia: histomorphometric differences in lung biopsies. J Bras Pneumol 2009; 35 (6): 529–40.
40. Peters-Golden M, Wise RA, Schneider P et al. Clinical and demographic predictors of loss of pulmonary function in systemic sclerosis. Medicine Baltimore 1984; 63 (4): 221–31.
41. Remy-Jardin M, Remy J, Wallaert B. Pulmonary involvement in progressive systemic sclerosis sequential evaluation with CT, pulmonary tests and broncho-alveolar lavage. Radiology 1993; 188: 499–506.
42. Ruangjutipopan S, Kasitanon N, Louthrenoo W et al. Causes of death and poor survival prognostic factors in thai patients with systemic sclerosis. J Med Assoc Thai 2002; 85 (11): 1204–9.
43. Sallam H, McNearney TA, Chen JD. Systematic review: pathophysiology and management of gastrointestinal dysmotility in systemic sclerosis (scleroderma). Aliment Pharmacol Ther 2006; 23: 691–712.
44. Savarino E, Bazzica M, Zentilin P et al. Gastroesophagealreflux and pulmonary fibrosis in scleroderma: a study using pH-impedance monitoring. Am J Respir Crit Care Med 2009; 179: 408–13.
45. Schurawitzki H, Stiglbauer R, Graninger W et al. Interstitial lung disease in progressive systemic sclerosis: high-resolution CT versus radiography. Radiology 1990; 176 (3): 755–9.
Авторы
А.В.Сосновская*, В.В.Фомин, М.В.Лебедева, Е.Н.Попова, Н.А.Мухин
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*antonina.sosnovskaya@live.de
ГБОУ ВПО Первый Московский государственный медицинский университет им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*antonina.sosnovskaya@live.de
________________________________________________
A.V.Sosnovskaya*, V.V.Fomin, M.V.Lebedeva, E.N.Popova, N.A.Muhin
I.M.Sechenov First Moscow State Medical University. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*antonina.sosnovskaya@live.de
I.M.Sechenov First Moscow State Medical University. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*antonina.sosnovskaya@live.de
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