不明原因胃肠道出血患者胶囊内镜检查阳性结果相关的临床因素：一项单中心研究
Clinical factors associated with positive capsule endoscopy findings in patients with obscure gastrointestinal bleeding: a single-center study.
作者信息
Shimada Sunao, Watanabe Toshio, Nadatani Yuji, Otani Koji, Taira Koichi, Hosomi Shuhei, Nagami Yasuaki, Tanaka Fumio, Kamata Noriko, Yamagami Hirokazu, Tanigawa Tetsuya, Shiba Masatsugu, Fujiwara Yasuhiro
机构信息
a Department of Gastroenterology , Osaka City University Graduate School of Medicine , Osaka , Japan.
出版信息
Scand J Gastroenterol. 2017 Nov;52(11):1219-1223. doi: 10.1080/00365521.2017.1349174. Epub 2017 Jul 10.
BACKGROUND
Capsule endoscopy (CE) is a useful tool for patients with obscure gastrointestinal bleeding (OGIB), but positive finding rate differs among trials, which may be attributable to the difference in patients' background.
OBJECTIVES
To evaluate the predictive factors associated with positive findings on CE.
METHODS
Consecutive patients with OGIB who underwent CE between March 2004 and May 2015 at a single university hospital were enrolled. Patients' clinical factors and CE data were reviewed retrospectively, and we evaluated the relationship between clinical factors and positive findings by univariate and multivariate logistic regression analyses.
RESULTS
Five hundred and seventy-eight patients were included in the analysis. Positive CE findings were obtained in 284 patients (49.1%). In multivariate analysis, low hemoglobin level (odds ratio (OR), 1.142 per 1 g/dL decrease; p < .001), Charlson comorbidity index (CCI) score (OR, 1.170 per 1 point increase; p = .002), and non-steroidal anti-inflammatory drug (NSAID) use (OR, 1.640; p = .044) were associated with an increased prevalence of positive findings. As for components of CCI, malignant tumor (OR, 1.839; p = .017) was associated with the positive findings.
CONCLUSIONS
OGIB patient with a low-hemoglobin level, complex and severe comorbidities, and NSAID use should receive CE.
背景
胶囊内镜检查（CE）是诊断不明原因消化道出血（OGIB）患者的一种有用工具，但不同试验中的阳性发现率有所不同，这可能归因于患者背景的差异。
目的
评估与CE阳性发现相关的预测因素。
方法
纳入2004年3月至2015年5月在某单一大学医院接受CE检查的连续OGIB患者。回顾性分析患者的临床因素和CE数据，通过单因素和多因素逻辑回归分析评估临床因素与阳性发现之间的关系。
结果
578例患者纳入分析。284例（49.1%）患者CE检查有阳性发现。多因素分析显示，血红蛋白水平降低（比值比（OR），每降低1 g/dL为1.142；p < 0.001）、查尔森合并症指数（CCI）评分（OR，每增加1分1.170；p = 0.002）和使用非甾体抗炎药（NSAID）（OR，1.640；p = 0.044）与阳性发现患病率增加相关。就CCI的组成部分而言，恶性肿瘤（OR，1.839；p = 0.017）与阳性发现相关。
结论
血红蛋白水平低、合并症复杂严重且使用NSAID的OGIB患者应接受CE检查。
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