Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
PLoS One. 2022 Mar 24;17(3):e0265903. doi: 10.1371/journal.pone.0265903. eCollection 2022.
Capsule endoscopy has been widely used to investigate obscure gastrointestinal bleeding (OGIB) in the small intestine since its approval in 2001. However, the clinical features of OGIB remain unclear.
We retrospectively examined the clinical features and risk factors of OGIB in patients who underwent capsule endoscopy in our hospital.
We included 420 of the 431 patients who underwent capsule endoscopy from June 2014 to May 2021, in whom the small intestine could be observed. We retrospectively compared the clinical features and treatment of OGIB cases, with or without active small bowel bleeding (n = 173), with other cases (n = 247). Patient sex, age, diabetes mellitus, and heart failure histories were matched for the analysis.
The male/female ratio was 247/173 and the average age was 51.54 years. In multivariate analysis, the use of direct oral anticoagulants was significant (P = 0.016), and vascular lesions (P = 0.018) were observed in OGIB cases. When OGIB cases with and without active small bowel bleeding were compared, serum albumin level was lower in cases with active bleeding (P = 0.031). When treatment of OGIB cases were compared, those without vascular lesions could be treated conservatively (P = 0.0047). In the 1:1 propensity score matching analysis, serum creatinine level was elevated in cases of active bleeding (P = 0.029), and cases without vascular lesions were treated conservatively (P = 0.010).
Use of direct oral anticoagulants is frequently associated with OGIB. OGIB patients without vascular lesions may be treated conservatively.
自 2001 年胶囊内镜获得批准以来，其已被广泛用于小肠不明原因胃肠道出血（OGIB）的检查。然而，OGIB 的临床特征仍不清楚。
我们回顾性研究了我院胶囊内镜检查的 OGIB 患者的临床特征和危险因素。
我们纳入了 2014 年 6 月至 2021 年 5 月期间在我院接受胶囊内镜检查且小肠可被观察到的 431 例患者中的 420 例。我们回顾性比较了有（n=173）和无（n=247）活动性小肠出血的 OGIB 患者的临床特征和治疗情况。为了进行分析，对患者的性别、年龄、糖尿病和心力衰竭病史进行了匹配。
男/女比例为 247/173，平均年龄为 51.54 岁。多变量分析显示，直接口服抗凝剂的使用有显著差异（P=0.016），OGIB 病例中存在血管病变（P=0.018）。当比较有和无活动性小肠出血的 OGIB 病例时，有活动性出血的病例血清白蛋白水平较低（P=0.031）。当比较 OGIB 病例的治疗时，无血管病变的病例可以保守治疗（P=0.0047）。在 1:1 倾向评分匹配分析中，有活动性出血的病例血清肌酐水平升高（P=0.029），无血管病变的病例保守治疗（P=0.010）。
直接口服抗凝剂的使用与 OGIB 密切相关。无血管病变的 OGIB 患者可能可以保守治疗。
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