在普通人群和高危人群中进行乳糜泻筛查。
Screening for celiac disease in the general population and in high-risk groups.
机构信息
Department of Paediatrics, Örebro University Hospital, Örebro, Sweden ; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Department of Epidemiology and Public Health, University of Nottingham, Nottingham, UK.
出版信息
United European Gastroenterol J. 2015 Apr;3(2):106-20. doi: 10.1177/2050640614561668.
BACKGROUND
Celiac disease (CD) occurs in approximately 1% of the Western population. It is a lifelong disorder that is associated with impaired quality of life (QOL) and an excessive risk of comorbidity and death.
OBJECTIVES
To review the literature on screening for CD in relation to the current World Health Organization (WHO) criteria for mass screening.
METHODS
We performed a PubMed search to identify indexed papers on CD screening with a publication date from 1900 until 1 June 2014. When we deemed an abstract relevant, we read the corresponding paper in detail.
RESULTS
CD fulfills several WHO criteria for mass screening (high prevalence, available treatment and difficult clinical detection), but it has not yet been established that treatment of asymptomatic CD may reduce the excessive risk of severe complications, leading to higher QOL nor that it is cost-effective.
CONCLUSIONS
Current evidence is not sufficient to support mass screening for CD, but active case-finding may be appropriate, as we recognize that most patients with CD will still be missed by this strategy. Although proof of benefit is still lacking, screening for CD may be appropriate in high-risk groups.
背景
乳糜泻（CD）在西方人群中约占 1%。这是一种终身性疾病，与生活质量（QOL）受损以及合并症和死亡风险过高有关。
目的
根据世界卫生组织（WHO）目前的大规模筛查标准，对 CD 筛查相关文献进行综述。
方法
我们在 PubMed 上进行了检索，以查找自 1900 年至 2014 年 6 月 1 日期间发表的关于 CD 筛查的索引文献。当我们认为某篇摘要具有相关性时，我们会详细阅读相应的论文。
结果
CD 符合 WHO 大规模筛查的几个标准（高患病率、可获得的治疗方法和临床检测困难），但尚未确定无症状 CD 的治疗是否可以降低严重并发症的过高风险，从而提高生活质量，也尚未确定这种治疗是否具有成本效益。
结论
目前的证据不足以支持 CD 的大规模筛查，但积极的病例发现可能是合适的，因为我们认识到，通过这种策略仍会遗漏大多数 CD 患者。尽管仍然缺乏获益的证据，但在高危人群中筛查 CD 可能是合适的。
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