JCC:胃肠道超声检查在监测妊娠炎症性肠病患者中的作用

2020-05-03 MedSci原创 MedSci原创

炎症性肠病(IBD)的治疗管理在妇女生育期间会受到影响,而胃肠超声检查(GIUS)可以准确识别非孕妇IBD患者的疾病活动,本项研究旨在确定GIUS在评估妊娠过程中IBD的可行性和准确性。

背景和目标: 炎症性肠病(IBD)的治疗管理在妇女生育期间会受到影响,而胃肠超声检查(GIUS)可以准确识别非孕妇IBD患者的疾病活动,本项研究旨在确定GIUS在评估妊娠过程中IBD的可行性和准确性。

方法: 研究人员对IBD妇女在怀孕期间接受GIUS进行一项多中心观察性研究。临床医生评估了四个结肠段和末端回肠和疾病活动的程度。同时记录子宫的位置。将GIUS疾病活动(肠壁厚度> 3mm)与生化疾病活动(粪便钙卫蛋白>100μg/ g)进行比较。

结果: 本项研究共包括90例患者和127例GIUS检查(中位妊娠19周,范围4-33)。在116/127(91%)扫描中获得了足够的结肠视图。<20周的62/67(93%)扫描和20-26周的30/51(59%)扫描获得了足够的回肠视图。肠壁厚度与钙卫蛋白之间存在正相关(r = 0.26,p = 0.03)。与钙卫蛋白相比,GIUS的特异性为83%,敏感性为74%,阴性预测值为90%。

结论: GIUS是监测妊娠IBD的可行且准确的方法。在大多数妊娠20周以内的患者中,可以获得足够的GIUS对结肠和回肠末端的视野。超过20周,GIUS可以很好地观察结肠,但是回肠末端变得难以评估。

原始出处:

Emma Flanagan. Et al. Monitoring Inflammatory Bowel Disease in Pregnancy using Gastrointestinal Ultrasonography. Journal of Crohn's and Colitis.2020.

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