Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, Chapel Hill, 27599-7080, USA.
Aliment Pharmacol Ther. 2010 Dec;32(11-12):1373-82. doi: 10.1111/j.1365-2036.2010.04476.x. Epub 2010 Oct 5.
Although consensus guidelines for eosinophilic oesophagitis have been published, it remains unclear whether gastroenterologists follow these recommendations.
To assess academic and community practice patterns for the evaluation and treatment of eosinophilic oesophagitis and to compare these practices with current guidelines.
This was a prospective study of academic and community gastroenterologists using a self-administered online survey.
A total of 60% (34 of 57) of academic and 29% (38 of 133) of community gastroenterologists completed the survey. Only 24% of academic and 3% of community gastroenterologists follow consensus guidelines to diagnose eosinophilic oesophagitis (P = 0.007). A proton pump inhibitor trial or negative pH study prior to diagnosis was required by just 25% of all gastroenterologists. A majority (60%) do not use the recommended threshold of 15 eosinophils per high powered field to diagnosis eosinophilic oesophagitis. Half (51%) mistakenly require a positive endoscopic finding. For first-line treatment, about half of the gastroenterologists surveyed treat with a swallowed topical steroid (53% academic, 56% community; P = N.S.), consistent with the guidelines.
There is variability in practice patterns for both diagnosis and treatment of eosinophilic oesophagitis. Ongoing education and research concerning diagnosis and treatment are needed.
尽管已经发布了嗜酸粒细胞性食管炎的共识指南，但尚不清楚胃肠病学家是否遵循这些建议。
评估学术和社区实践中评估和治疗嗜酸粒细胞性食管炎的模式，并将这些实践与当前指南进行比较。
这是一项针对学术和社区胃肠病学家的前瞻性研究，采用自我管理的在线调查。
共有 60%（57 名中的 34 名）的学术和 29%（133 名中的 38 名）社区胃肠病学家完成了调查。只有 24%的学术和 3%的社区胃肠病学家遵循共识指南来诊断嗜酸粒细胞性食管炎（P = 0.007）。质子泵抑制剂试验或 pH 值阴性研究在诊断前仅被 25%的胃肠病学家要求。大多数（60%）不使用建议的 15 个高倍视野每高倍视野嗜酸粒细胞的阈值来诊断嗜酸粒细胞性食管炎。有一半（51%）错误地需要阳性内镜发现。对于一线治疗，约一半的接受调查的胃肠病学家使用口服局部类固醇治疗（学术组 53%，社区组 56%；P = 无统计学意义），这与指南一致。
嗜酸粒细胞性食管炎的诊断和治疗实践模式存在差异。需要开展关于诊断和治疗的持续教育和研究。
