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对囊性纤维化患者的腹部症状进行评分

Scoring Abdominal Symptoms in People with Cystic Fibrosis.

作者信息

Tabori Harold, Barucha Anton, Zagoya Carlos, Duckstein Franziska, Dunay Gabor A, Sadrieh Pauline, Polte Louise, Mainz Jochen G

机构信息

Cystic Fibrosis Centre, Brandenburg Medical School (MHB) University, Klinikum Westbrandenburg, 14770 Brandenburg an der Havel, Germany.

Alexianer St. Hedwig Kliniken Berlin GmbH Hospital, Gastroenterology, Internal Medicine, 12526 Berlin, Germany.

出版信息

J Clin Med. 2024 Mar 13;13(6):1650. doi: 10.3390/jcm13061650.

Abstract

(1) Background: The introduction of highly effective CFTR-modulating therapies (HEMT) has changed the course of the disease for many people with Cystic Fibrosis (pwCF). Attention previously focused on life-threatening conditions of the respiratory system has broadened, bringing the involvement of the digestive system into the clinical and scientific focus. This emphasized the need for sensitive tools to capture and quantify changes in abdominal symptoms (AS), ideally applying patient-reported outcome measures (PROMs). (2) Methods: The present review focuses on studies addressing AS assessment deriving from the multi-organic abdominal involvement in pwCF. Among 5224 publications retrieved until Nov. 2022, 88 were eligible, and 39 were finally included. (3) Results: The review reveals that for a long time, especially before HEMT availability, AS in pwCF were assessed by single questions on abdominal complaints or non-validated questionnaires. PROMs focusing on quality of life (QOL) including a few GI-related questions were applied. Likewise, PROMs developed and partially validated for other non-CF GI pathologies, such as chronic inflammatory bowel diseases, irritable bowel syndrome, gastroesophageal reflux, constipation, or pancreatitis, were implemented. (4) Conclusions: Only lately, CF-specific GI-PROMs have been developed and validated following FDA guidelines, showing high sensitivity to changes and capturing marked and statistically significant reductions in the burden of AS achieved with HEMT implementation.

摘要

(1) 背景:高效CFTR调节剂疗法(HEMT)的引入改变了许多囊性纤维化患者(pwCF)的疾病进程。此前对呼吸系统危及生命状况的关注范围已扩大,消化系统的受累情况也进入了临床和科研焦点。这凸显了需要灵敏的工具来捕捉和量化腹部症状(AS)的变化,理想情况下应采用患者报告结局测量(PROMs)。(2) 方法:本综述聚焦于探讨pwCF多器官腹部受累所衍生的AS评估的研究。在截至2022年11月检索到的5224篇出版物中,88篇符合条件,最终纳入39篇。(3) 结果:该综述表明,长期以来,尤其是在HEMT可用之前,pwCF的AS是通过关于腹部不适的单一问题或未经验证的问卷进行评估的。应用了关注生活质量(QOL)包括一些胃肠道相关问题的PROMs。同样,也采用了针对其他非CF胃肠道疾病(如慢性炎症性肠病、肠易激综合征、胃食管反流、便秘或胰腺炎)开发并部分验证的PROMs。(4) 结论:直到最近,才按照美国食品药品监督管理局(FDA)的指南开发并验证了CF特异性胃肠道PROMs,其对变化具有高敏感性,并能捕捉到随着HEMT实施腹部症状负担显著且具有统计学意义的减轻。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/312e/10971656/dd706a136038/jcm-13-01650-g003.jpg

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