Pediatrics:无创检查诊断小儿炎症性肠病的指标有哪些?

2015-12-21 Seven L 译 MedSci原创

小儿炎症性肠病(IBD)的临床表现通常不具有特异性,还会误诊为功能性胃肠疾病。研究者检索相关数据库,分析关于儿童慢性胃肠道症状中IBD诊断方式精确性的研究,IBD经过内窥镜检查和组织病理学或临床随访以确定。以探究症状、体征、非侵入性检查等对IBD诊断的精确性。该荟萃分析纳入了19篇研究,涉及2806名患者。研究数据显示,症状如腹痛、腹泻、直肠出血、体重下降等诊断IBD敏感性0.48-0.82,特异

小儿炎症性肠病(IBD)的临床表现通常不具有特异性,常会被误诊为功能性胃肠疾病。研究者检索相关数据库,分析关于儿童慢性胃肠道症状中IBD诊断方式精确性的研究,IBD经过内窥镜检查和组织病理学或临床随访以确定。以探究症状、体征、非侵入性检查等对IBD诊断的精确性。

该荟萃分析纳入了19篇研究,涉及2806名患者。研究数据显示,症状如腹痛、腹泻、直肠出血、体重下降等诊断IBD敏感性0.48-0.82,特异性0.17-0.78。对于血液检查诊断IBD,C反应蛋白(9项研究)和白蛋白(6项研究)表现最佳,敏感性分别为 0.63 (0.51-0.73) 和0.48 (0.31-0.66),特异性分别为0.88 (0.80-0.93)和0.94 (0.86-0.98)。粪便钙卫蛋白 (FCal)(10项研究)诊断IBD的敏感性和特异性分别为0.99 (0.92-1.00) 和(0.54-0.74)。

荟萃分析结果表明,当根据小儿患者症状无法诊断IBD时,使用FCal、CRP和白蛋白具有潜在的临床价值,可选择出IBD低风险(FCal结果阴性)或高风险患者(CRP、白蛋白阳性),进而避免内窥镜等有创检查。

原始出处:

Holtman GA, Lisman-van Leeuwen Y,et al.Noninvasive Tests for Inflammatory Bowel Disease: A Meta-analysis.Pediatrics. 2015 Dec 17. pii: peds.2015-2126.

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    2016-10-14 hbwxf
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    2016-09-28 feather89
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    2016-01-27 1de3b290m83(暂无匿称)

    要开展

    0

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    2015-12-24 田田1746

    有点难

    0

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