Sandborn W J, Tremaine W J, Batts K P, Pemberton J H, Phillips S F
Inflammatory Bowel Disease Clinic, Mayo Clinic Rochester, MN 55905.
Mayo Clin Proc. 1994 May;69(5):409-15. doi: 10.1016/s0025-6196(12)61634-6.
To develop a "Pouchitis Disease Activity Index" (PDAI) and to compare it with other diagnostic scoring systems for pouchitis.
We compared patients who had an optimal outcome with those who had a poor result attributable to recurrent pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis at the Mayo Clinic.
We evaluated the applicability of a PDAI that quantitated clinical findings and the endoscopic and histologic features of acute inflammation in four groups of patients: (1) 10 who underwent IPAA for ulcerative colitis and had symptoms compatible with a clinical diagnosis of pouchitis, (2) 5 who underwent IPAA for ulcerative colitis and did not have pouchitis, (3) 5 who underwent IPAA for familial adenomatous polyposis and had no symptoms of pouchitis, and (4) 5 who had a Brooke ileostomy for ulcerative colitis (control group).
The PDAI was significantly greater in patients with the clinical features of pouchitis than it was for patients in the other three groups. All 10 patients with pouchitis fulfilled the PDAI criteria for a diagnosis of pouchitis; in contrast, only 1 of these 10 patients met the diagnostic criteria for pouchitis by application of previously established scoring systems. No asymptomatic patient qualified for a diagnosis of pouchitis by the PDAI criteria.
The PDAI provides simple, objective, and quantitative criteria for pouch inflammation after IPAA and is more sensitive than prior scoring systems.
制定“袋炎疾病活动指数”（PDAI），并将其与其他袋炎诊断评分系统进行比较。
我们在梅奥诊所比较了因溃疡性结肠炎行回肠储袋肛管吻合术（IPAA）后结局良好的患者与因复发性袋炎结局不佳的患者。
我们评估了一种PDAI的适用性，该指数对四组患者的临床发现以及急性炎症的内镜和组织学特征进行量化：（1）10例因溃疡性结肠炎行IPAA且有与袋炎临床诊断相符症状的患者；（2）5例因溃疡性结肠炎行IPAA但无袋炎的患者；（3）5例因家族性腺瘤性息肉病行IPAA且无袋炎症状的患者；（4）5例因溃疡性结肠炎行布鲁克回肠造口术的患者（对照组）。
有袋炎临床特征的患者的PDAI显著高于其他三组患者。所有10例袋炎患者均符合PDAI的袋炎诊断标准；相比之下，这10例患者中只有1例通过应用先前建立的评分系统符合袋炎诊断标准。没有无症状患者符合PDAI标准的袋炎诊断。
PDAI为IPAA术后的袋炎提供了简单、客观和定量的标准，并且比先前的评分系统更敏感。
