Kim Wonshik, Lee Beomjae, Yoo Ahyoung, Kim Seunghan, Joo Moonkyung, Park Jong-Jae
Department of Gastroenterology, Korea University Guro Hospital, Seoul 08308, Korea.
Diagnostics (Basel). 2021 Nov 16;11(11):2123. doi: 10.3390/diagnostics11112123.
Video capsule endoscopy (VCE) is an effective diagnostic modality for detecting small bowel lesions. However, the value of VCE for patients with chronic recurrent abdominal pain (CAP) of unknown etiology remains obscure. We retrospectively analyzed factors that could predict enteropathy based on the medical records of 65 patients with unexplained chronic recurrent abdominal pain (CAP) who were assessed using VCE between 2001 and 2021. We also conducted a systematic review and meta-analysis of the literature to validate our results. The positive findings of 27 (41.5%) of the 65 patients were mostly ulcerative lesions including stricture ( = 14, 60.9%) and erosion ( = 8, 29.7%). Multivariate analysis identified elevated ESR (OR, 1.06, 95% CI, 1.02-1.1, = 0.004) as a significant risk factor for enteropathy predicted by VCE. Three eligible studies in the meta-analysis included 523 patients with CAP. Elevated C-reactive protein (CRP) (OR, 14.09; 95% CI, 2.81-70.60; = 0.001) and erythrocyte sedimentation rate (ESR) (OR, 14.45; 95% CI, 0.92-227.33; = 0.06) indicated VCE-positive findings in patients with unexplained abdominal pain. Elevated levels of the inflammatory markers ESR and CRP can thus predict positive VCE findings in patients with CAP.
视频胶囊内镜检查(VCE)是检测小肠病变的一种有效诊断方法。然而,VCE对于病因不明的慢性复发性腹痛(CAP)患者的价值仍不明确。我们基于2001年至2021年间接受VCE评估的65例不明原因慢性复发性腹痛(CAP)患者的病历,回顾性分析了可预测肠病的因素。我们还对文献进行了系统评价和荟萃分析以验证我们的结果。65例患者中有27例(41.5%)检查结果呈阳性,主要为溃疡性病变,包括狭窄(14例,60.9%)和糜烂(8例,29.7%)。多变量分析确定血沉(ESR)升高(比值比,1.06;95%置信区间,1.02 - 1.1;P = 0.004)是VCE预测肠病的一个显著危险因素。荟萃分析中的三项符合条件的研究纳入了523例CAP患者。C反应蛋白(CRP)升高(比值比,14.09;95%置信区间,2.81 - 70.60;P = 0.001)和血沉(ESR)升高(比值比,14.45;95%置信区间,0.92 - 227.33;P = 0.06)表明不明原因腹痛患者VCE检查结果呈阳性。因此,炎症标志物ESR和CRP水平升高可预测CAP患者VCE检查结果呈阳性。