Department of Gastroenterology, UC Davis Medical Center, Sacramento, California 95817-1460, USA.
J Dig Dis. 2011 Oct;12(5):357-63. doi: 10.1111/j.1751-2980.2011.00520.x.
Video capsule endoscopy (VCE) is an important tool for non-invasive imaging of the small bowel. Whether there is a dose-related effect of anemia severity on the diagnostic yield of VCE is unknown. The aim of this study was to determine the influence of anemia severity on VCE outcome measures.
VCE studies from the Sacramento Veterans Affairs Medical Center for 300 consecutive patients were retrospectively screened. Those with anemia were selected. Patients were grouped as mildly, moderately or severely bleeding. Outcomes data including completion of study, diagnostic yield and further intervention were compared.
Of the 300 patients, 210 (70%) were found to have anemia. Overall 32 (15.24%) patients were mildly, 145 (69.05%) were moderately and 33 (15.71%) were severely bleeding. The diagnostic yield was significantly higher in severe (72.73%) relative to moderate (32.41%) and mild bleeding (12.50%); P = 0.0001. Significantly more angioectasias were detected in severely bleeding patients (42.42%) than in those bleeding moderately (14.48%) and mildly (0.00%), P = 0.0001. The ability of VCE to guide further intervention was significantly higher in patients bleeding severely (69.70%, P = 0.006).
Our data showed a significant increase in diagnostic yield with the increasing degree of anemia. Relative difference in hemoglobin rather than absolute values may be a better predictor. The ability of VCE to guide further intervention reached significance in severely bleeding patients. The hypothesis that use of VCE prior to esophagogastroduodenoscopy or colonoscopy in the severely bleeding group deserves to be evaluated.
视频胶囊内镜（VCE）是一种对小肠进行非侵入性成像的重要工具。贫血严重程度对 VCE 诊断率是否存在剂量相关影响尚不清楚。本研究旨在确定贫血严重程度对 VCE 结果指标的影响。
回顾性筛选萨克拉门托退伍军人事务医疗中心的 300 例连续 VCE 研究。选择有贫血的患者。将患者分为轻度、中度或重度出血。比较研究完成情况、诊断率和进一步干预的结果数据。
在 300 例患者中，210 例（70%）发现有贫血。总体而言，32 例（15.24%）为轻度、145 例（69.05%）为中度和 33 例（15.71%）为重度出血。严重出血组（72.73%）的诊断率明显高于中度（32.41%）和轻度（12.50%）；P=0.0001。重度出血患者（42.42%）明显比中度（14.48%）和轻度（0.00%）出血患者检出更多的血管畸形；P=0.0001。严重出血患者 VCE 指导进一步干预的能力明显更高（69.70%，P=0.006）。
我们的数据显示，随着贫血程度的增加，诊断率显著增加。血红蛋白的相对差异而不是绝对值可能是更好的预测指标。严重出血患者 VCE 指导进一步干预的能力达到显著水平。在严重出血组中，VCE 在进行食管胃十二指肠镜检查或结肠镜检查之前使用的假设值得评估。
