系统性重复测试：抑制条件的潜在高估。

Systematic Retesting for : The Potential Overestimation of Suppressive Conditions.

机构信息

Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, Georg-August University, Göttingen, Germany.

Department of Gastroenterology, Internal Medicine and Geriatrics, Rems-Murr Hospital, Winnenden, Germany.

出版信息

Biomed Res Int. 2022 Apr 25;2022:5380001. doi: 10.1155/2022/5380001. eCollection 2022.

DOI:10.1155/2022/5380001

PMID:35509714

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9060991/

Abstract

BACKGROUND AND AIMS

In contrast to guideline recommendations, endoscopic testing for is frequently performed under suppressive conditions, e.g., intake of proton-pump inhibitors (PPI), preceded antibiotic treatment, or recent gastrointestinal bleeding. Our study's aim was to retest patients with-under suppressive conditions-negative test results. This was carried out in order to examine the rate of false negative tests previously gathered under suppressive conditions.

METHODS

The trial was conducted in a large patient collective in a university hospital. Every elective esophagogastroduodenoscopy from in- and outpatients was included. Prior to endoscopy, suppressive conditions were collected via standardized questionnaire. If testing was indicated, both helicobacter urease test and histology were performed in analogy to the Sydney classification. In case of a negative result under suppressive conditions, the patient was reinvited after, if possible, withdrawal of suppressive condition in order to perform a urea breath test (UBT).

RESULTS

1,216 patients were included (median 59 years, 72.0% inpatients, 28.0% outpatients). Overall, 60.6% (737) were under suppressive conditions. The main suppressive condition was intake of PPIs (54.5%). In 53.7% (653) of all included cases, testing was performed. Of those, 14.1% (92) had a positive test, and 85.9% (561) were negative. Out of the patients with negative result, 50.8% (285) were tested under suppressive conditions and consequently invited for retesting via UBT. In 20.4% (45), suppressive conditions could not be ceased. In 22.8% (65), retesting was conducted. Of those, 98.5% (64) congruently presented a negative result again, and only 1.5% (1) was positive for .

CONCLUSION

Many patients undergoing esophagogastroduodenoscopy in everyday clinical practice are tested for under suppressive conditions leading to a potentially higher risk of false negative results. However, our research shows that this issue might be overestimated.

摘要

背景与目的

与指南建议相反，在抑制条件下（例如，质子泵抑制剂（PPI）的摄入、抗生素治疗前或最近的胃肠道出血）下，经常对进行内镜检查。我们研究的目的是重新检测在抑制条件下呈阴性测试结果的患者。这样做是为了检查以前在抑制条件下收集的假阴性测试的比率。

方法

该试验在一家大学医院的大型患者群体中进行。纳入了每例门诊和住院患者的选择性食管胃十二指肠镜检查。在进行内镜检查之前，通过标准化问卷收集抑制条件。如果需要进行检测，则按照悉尼分类法同时进行幽门螺杆菌尿素酶试验和组织学检查。如果在抑制条件下呈阴性结果，则在可能停用抑制条件后，邀请患者重新进行尿素呼气试验（UBT）。

结果

共纳入 1216 例患者（中位数年龄为 59 岁，72.0%为住院患者，28.0%为门诊患者）。总体而言，60.6%（737 例）的患者处于抑制状态。主要抑制条件是 PPI 的摄入（54.5%）。在所有纳入的病例中，53.7%（653 例）进行了检测。其中，14.1%（92 例）检测结果为阳性，85.9%（561 例）为阴性。在所有阴性结果的患者中，50.8%（285 例）在抑制条件下进行了检测，并因此通过 UBT 受邀进行了重新检测。在 20.4%（45 例）的情况下，无法停止抑制条件。在 22.8%（65 例）的情况下，进行了重新检测。其中，98.5%（64 例）再次呈现阴性结果，只有 1.5%（1 例）为阳性。