Shen B, Achkar J P, Lashner B A, Ormsby A H, Remzi F H, Bevins C L, Brzezinski A, Petras R E, Fazio V W
Department of Gastroenterology, Center for Inflammatory Bowel Disease, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, Ohio 44195, USA.
Gastroenterology. 2001 Aug;121(2):261-7. doi: 10.1053/gast.2001.26290.
BACKGROUND & AIMS: Pouchitis often is diagnosed based on symptoms alone. In this study, we evaluate whether symptoms correlate with endoscopic and histologic findings in patients with ulcerative colitis and an ileal pouch-anal anastomosis.
Symptoms, endoscopy, and histology were assessed in 46 patients using Pouchitis Disease Activity Index (PDAI). Patients were classified as either having pouchitis (PDAI score > or =7; N = 22) or as not having pouchitis (PDAI score <7; N = 24).
Patients with pouchitis had significantly higher mean total PDAI scores, symptom scores, endoscopy scores, and histology scores. There was a similar magnitude of contribution of each component score to the total PDAI for the pouchitis group. Of note, 25% of patients with symptoms suggestive of pouchitis did not meet the PDAI diagnostic criteria for pouchitis. In both groups, the correlation coefficients between symptom, endoscopy, and histology scores were near zero (range, -0.26 to 0.20; P > 0.05).
The symptom, endoscopy, and histology scores each contribute to the PDAI and appear to be independent of each other. Symptoms alone do not reliably diagnose pouchitis.
袋炎通常仅依据症状进行诊断。在本研究中，我们评估了溃疡性结肠炎和回肠袋肛管吻合术患者的症状与内镜及组织学检查结果之间是否存在相关性。
使用袋炎疾病活动指数（PDAI）对46例患者的症状、内镜检查和组织学进行评估。患者被分为患有袋炎（PDAI评分≥7；n = 22）或未患袋炎（PDAI评分<7；n = 24）。
患有袋炎的患者平均总PDAI评分、症状评分、内镜检查评分和组织学评分显著更高。对于袋炎组，各成分评分对总PDAI的贡献幅度相似。值得注意的是，25%有袋炎症状提示的患者未达到袋炎的PDAI诊断标准。在两组中，症状、内镜检查和组织学评分之间的相关系数接近零（范围为-0.26至0.20；P>0.05）。
症状、内镜检查和组织学评分均对PDAI有贡献，且似乎相互独立。仅依靠症状不能可靠地诊断袋炎。
