改善的准则遵守和PPI有效性伴随着诊断延迟的减少,在北丹麦地区诊断异性食道炎之前的狭窄 - - DanEoE队列的回顾性注册表研究
Dorte Melgaard1, Amalie Byrholdt Hansen2, Camilla Pedersen2
1MechSense, Department of Gastroenterology and Hepatology, Aalborg University Hospital, Hobrovej 18-22, Aalborg 9000, Denmark; Department of Clinical Medicine, Aalborg University, Søndre Skovvej 15, Aalborg 9000, Denmark.
Clinics and research in hepatology and gastroenterology
|June 12, 2023
概括
在丹麦,对乙酸性食道炎 (EoE) 的认识增加,导致诊断延迟减少,并发症减少. 这项研究强调了经过更新的EoE诊断协议后,改善了患者的治疗结果和指导方针的遵守.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 在2011年之后,在实施区域活检指南后,在丹麦北部提高了对乙酸性食道炎 (EoE) 的认识.
- 在2007-2017年间,观察到EoE发病率增加了50倍,这表明诊断和意识的提高.
研究的目的:
- 评估自2017年以来在诊断延迟,并发症率,质子抑制剂 (PPI) 治疗和丹麦EoE患者的随访护理方面的进展.
- 将当前的EoE患者数据与历史队列进行比较,以评估更新指南和提高认识的影响.
主要方法:
- 在2018年至2021年期间诊断出346名成人EoE患者的回顾性注册表和基于人口的队列研究 (DanEoE2队列).
- 利用丹麦病理组织学注册表和SNOMED系统进行全面的患者纳入.
- 结果与之前的DanEoE队列 (2007-2017) 进行了比较.
主要成果:
- 对于EoE的中位诊断延迟减少了1.5年 (4.0年与5.5年相比,p=0.03).
- 在诊断前的狭窄形成显著减少 (3.2%对11.6%,p=0.003).
- 高剂量的PPI启动率增加 (88%对56%,p<0.001),组织学随访率改善 (74%对67%,p=0.05).
结论:
- 2017年后的队列表明诊断延迟减少,狭窄形成减少,并且更好地遵守国家对EoE的指南.
- 需要进行进一步的研究,以确定在PPI治疗中症状或组织学缓解是否最好预测EOE患者的并发症风险.
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