高于胰岛素抵抗百分比（IRP）：预测食管胃交界部流出道梗阻患者的异常确诊检查结果
Look above the IRP: predicting abnormal confirmatory testing in patients with esophagogastric junction outflow obstruction.
作者信息
Strauss Starling Alexandra, Thanawala Shivani U, Beveridge Claire A, Falk Gary W, Lynch Kristle L
机构信息
Division of Gastroenterology & Hepatology, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
Department of Gastroenterology and Hepatology, Digestive Disease and Surgery Institute, Cleveland Clinic Foundation, Cleveland, OH, USA.
出版信息
Therap Adv Gastroenterol. 2024 Dec 23;17:17562848241306128. doi: 10.1177/17562848241306128. eCollection 2024.
BACKGROUND
Esophagogastric junction outflow obstruction (EGJOO) is a manometric diagnosis based on Chicago Classification version 4.0 (CC4.0) that requires confirmatory testing for clinical relevancy. However, it is still unclear which patients will respond to therapy.
OBJECTIVES
To evaluate manometric and clinical predictors of abnormal confirmatory testing for patients with EGJOO.
DESIGN
This was a prospective observational study of patients with manometric EGJOO and chest pain or dysphagia who underwent confirmatory testing.
METHODS
Patients with EGJOO on manometry were enrolled and underwent timed barium esophagram or endoFLIP. A subset of patients was given validated surveys, including Eckardt scores (ES) and PROMIS-10.
RESULTS
For patients with a CC4.0 EGJOO diagnosis, abnormal peristalsis (OR = 7.0, 95% CI = 1.01-44.6, = 0.04) and increases in ES (OR = 2.34 95% CI = 1.13-4.86, = 0.02) were associated with positive confirmatory testing.
CONCLUSION
Patients with potentially actionable EGJOO were more likely to have an abnormal peristaltic subtype of EGJOO or higher ES.
背景
食管胃交界部流出道梗阻（EGJOO）是一种基于芝加哥分类第4版（CC4.0）的测压诊断，临床相关性需要进行验证性检查。然而，仍不清楚哪些患者对治疗有反应。
目的
评估EGJOO患者验证性检查异常的测压和临床预测因素。
设计
这是一项对有测压EGJOO且有胸痛或吞咽困难的患者进行的前瞻性观察研究，这些患者接受了验证性检查。
方法
纳入测压显示EGJOO的患者，并进行定时钡剂食管造影或腔内功能成像探头（endoFLIP）检查。一部分患者接受了经过验证的问卷调查，包括埃卡德特评分（ES）和患者报告结果测量信息系统简表10（PROMIS-10）。
结果
对于CC4.0诊断为EGJOO的患者，蠕动异常（比值比[OR]=7.0，95%置信区间[CI]=1.01-44.6，P=0.04）和ES升高（OR=2.34，95%CI=1.13-4.86，P=0.02）与验证性检查阳性相关。
结论
具有潜在可治疗性EGJOO的患者更有可能具有EGJOO的异常蠕动亚型或更高的ES。
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