伴有体重减轻的腹痛患者的胶囊内镜诊断率较高:一项韩国多中心研究  

Abdominal pain accompanied by weight loss may increase the diagnostic yield of capsule endoscopy:A Korean multicenter study

作　　者：Shim K.-N. Kim Y.-S. Kim K.-J. 沙焕臣 

机构地区：[1]Yang Hospital,424 Gil-dong,Gangdong-gu,134-814 Seoul,South Korea

出　　处：《世界核心医学期刊文摘（胃肠病学分册）》2006年第12期57-57,共1页Core Journals in Gastroenterology

摘　　要：Objective.Capsule endoscopy(CE) is approved for the eval-uation of obscure gastrointestinal(GI) bleeding and its use has increased in the assessment of patients with various small-bowel disorders.The yield of CE for indications of disorders other than GI bleeding is not yet well described.The aim of the present study was to determine in which subgroup of patients with unexplained abdominal pain,CE would be a helpful evaluation tool.Material and methods.The results of CE in 110 patients(70 M,40 F,mean age 50.8± 14.1 years) with unexplained abdominal pain from 12 tertiary referral centers between September 2002 and September 2004 were retrospectively analyzed.Results.The visualization of the small bowel to the cecum was successfully carried out in 69.1% of the patients.Nineteen out of the 110 cases revealed positive findings that explained the symptoms of the patient(diagnostic yield = 17.3%) .Diagnosis included small-bowel stricture(5) ,Crohn’s disease(3) ,small-bowel tumor(2) ,radiation-induced enteritis(1) ,NSAID-induced enteropathy(1) ,ischemic ileitis(1) ,diffuse lymphangiectasia(1) ,and sig-nificant erosion or ulceration(5) .By univariate logistic regression analysis,the positive findings of CE were significantly associated with weight loss(odds ratio(OR) ,11.9;95% CI [2.0,70.6]) ,elevated erythrocyte sedimentation rate(ESR) (>20 mm/h) (OR,11.5;95% CI(1.9,69.5) ) ,elevated C-reactive protein(CRP) (≥ 0.4 mg/dL) (OR,5.0;95% CI(1.6,15.9) ) ,and hypoalbuminemia(albumin < 3 g/dL) (OR,23.1;95% CI(2.4,223.1) ) .Using a multivariate analysis,weight loss was found to be a significant risk factor for positive findings of CE(OR,18.6;95% CI(1.6,222.4) ,p = 0.02) .Conclusions.The results of this study suggest that CE can be helpful in patients suffering from abdominal pain that cannot be explained by established examinations,if the pain is accompanied by weight loss.Objective.Capsule endoscopy(CE) is approved for the eval-uation of obscure gastrointestinal(GI) bleeding and its use has increased in the assessment of patients with various small-bowel disorders.The yield of CE for indications of disorders other than GI bleeding is not yet well described.The aim of the present study was to determine in which subgroup of patients with unexplained abdominal pain,CE would be a helpful evaluation tool.Material and methods.The results of CE in 110 patients(70 M,40 F,mean age 50.8± 14.1 years) with unexplained abdominal pain from 12 tertiary referral centers between September 2002 and September 2004 were retrospectively analyzed.Results.The visualization of the small bowel to the cecum was successfully carried out in 69.1% of the patients.Nineteen out of the 110 cases revealed positive findings that explained the symptoms of the patient(diagnostic yield = 17.3%) .Diagnosis included small-bowel stricture(5) ,Crohn's disease(3) ,small-bowel tumor(2) ,radiation-induced enteritis(1) ,NSAID-induced enteropathy(1) ,ischemic ileitis(1) ,diffuse lymphangiectasia(1) ,and sig-nificant erosion or ulceration(5) .By univariate logistic regression analysis,the positive findings of CE were significantly associated with weight loss(odds ratio(OR) ,11.9;95% CI [2.0,70.6]) ,elevated erythrocyte sedimentation rate(ESR) (>20 mm/h) (OR,11.5;95% CI(1.9,69.5) ) ,elevated C-reactive protein(CRP) (≥ 0.4 mg/dL) (OR,5.0;95% CI(1.6,15.9) ) ,and hypoalbuminemia(albumin < 3 g/dL) (OR,23.1;95% CI(2.4,223.1) ) .Using a multivariate analysis,weight loss was found to be a significant risk factor for positive findings of CE(OR,18.6;95% CI(1.6,222.4) ,p = 0.02) .Conclusions.The results of this study suggest that CE can be helpful in patients suffering from abdominal pain that cannot be explained by established examinations,if the pain is accompanied by weight loss.

关 键 词：胶囊内镜 诊断率 小肠疾病 不明原因腹痛 淋巴管扩张 小肠狭窄 克罗恩病 消化道出血 低蛋白血症 小 

分 类 号：R57[医药卫生—消化系统]