School of Medicine, University of Tampere, Tampere, Finland.
Dig Liver Dis. 2012 Oct;44(10):814-8. doi: 10.1016/j.dld.2012.04.019. Epub 2012 Jun 5.
Active serological screening has proved an effective means of increasing the diagnostic rate in celiac disease. The effects of a long-term gluten-free diet on possible gastrointestinal symptoms and psychological well-being in screen-detected patients have nevertheless remained obscure.
Abdominal symptoms and quality of life were measured in a large cohort of treated screen-detected celiac adults. Comparisons were made with corresponding symptom-detected patients and with non-celiac controls. Dietary adherence was assessed both by structured interview and by serological testing.
In both screen- and symptom-detected celiac groups, 88% of the patients were adherent. On a diet, both screen- and symptom-detected patients reported significantly more gastrointestinal symptoms than non-celiac controls. Those screen-detected patients who reported having no symptoms at the time of diagnosis, also remained asymptomatic during the diet. Despite persistent symptoms, psychological well-being in screen-detected patients was comparable with that in non-celiac controls, whereas the symptom-detected patients showed lower quality of life.
Long-term treated screen-detected celiac patients, especially women, suffer from gastrointestinal symptoms on a gluten free diet similarly to symptom-detected patients. However, despite a similar frequency of persistent symptoms, the quality of life was unimpaired in the screen found, but remained low in the symptom-detected group.
主动进行血清学筛查已被证明是提高乳糜泻诊断率的有效手段。然而，对于经筛查发现的患者，长期无麸质饮食对可能出现的胃肠道症状和心理健康的影响仍不清楚。
在一个大型经治疗的乳糜泻成年患者队列中，测量了腹部症状和生活质量。将其与相应的症状发现患者和非乳糜泻对照组进行了比较。通过结构化访谈和血清学检测评估了饮食的依从性。
在筛查和症状发现的乳糜泻组中，88%的患者依从饮食。在饮食期间，筛查和症状发现的乳糜泻患者均报告胃肠道症状明显多于非乳糜泻对照组。那些在诊断时无症状的筛查发现的患者，在饮食期间也无症状。尽管持续存在症状，但筛查发现的患者的心理健康状况与非乳糜泻对照组相当，而症状发现的患者的生活质量较低。
长期接受治疗的经筛查发现的乳糜泻患者，尤其是女性，在无麸质饮食时会出现胃肠道症状，与症状发现的患者相似。然而，尽管持续存在症状的频率相似，但在筛查发现的患者中，生活质量未受影响，但在症状发现的患者中仍较低。
