J Gastroenterology:气囊辅助小肠镜对小肠评估对于克罗恩病的临床意义

2020-11-14 MedSci原创 MedSci原创

克罗恩氏病(CD)的小肠病变已知与不良预后有关。但是,内窥镜治疗可以使患者获得良好的治疗效果。这项研究的目的是阐明使用球囊辅助肠镜检查(BAE)评估小肠病变(DSB)对CD患者临床缓解的临床影响。

背景及目的

克罗恩氏病(CD)的小肠病变已知与不良预后有关。但是,内窥镜治疗可以使患者获得良好的治疗效果。这项研究的目的是阐明使用球囊辅助肠镜检查(BAE)评估小肠病变(DSB)对CD患者临床缓解的临床影响。

 

 

方法

从2012年1月至2018年7月,研究人员共纳入100例临床缓解的CD患者,所有患者使用单气囊肠镜进行经肛门肠镜检查。使用部分CD的简单内镜评分(pSES-CD)对末端回肠(TI)进行内镜评估。DSB的内镜评估使用了改良的部分SES-CD(mpSES-CD)。我们评估了与复发相关的因素,以及TI和DSB之间内镜评分的相关性。复发的定义为肠镜检查后一年内住院情况。

 

 

结果

肠镜检查在一年内复发了30例患者(30.0%)。多元逻辑回归分析显示,Harvey–Bradshaw指数较高(OR 1.77,95%CI 1.18–2.65;p  = 0.003)和mpSES-CD评分在DSB处较差(OR 3.10,95%CI 1.86–5.15;p  = 0.001)是复发的独立危险因素在DSB处,复发率与mpSES-CD大于5之间存在显着的相关趋势。但是,TI的复发率与pSES-CD之间没有相关性。

 

 

结论

即使克罗恩病已缓解,使用BAE评估DSB来评估内镜黏膜愈合也很重要。

 

 

原始出处:

Kaoru Takabayashi. Et al. Significance of endoscopic deep small bowel evaluation using balloon-assisted enteroscopy for Crohn’s disease in clinical remission. J Gastroenterology.2020.

 

 

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