在慢性便秘的门诊患者中,高发病率的阳肠功能障碍,无论结肠过境时间如何
George Triadafilopoulos1,2, Megan Lee3, Leila Neshatian4
1Division of Gastroenterology and Hepatology, Stanford University School of Medicine, 420 Broadway Street, Pavilion D, 2nd Floor, Redwood City, CA, 94063, USA. vagt@stanford.edu.
伦敦分类显示,慢性便秘患者的阳肠疾病有显著的重叠,无论结肠过境时间如何. 在CC评估中,无线运动囊和高分辨率直肠测量仪的实用性需要进一步调查.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 身体生理学 身体生理学
背景情况:
- 慢性便秘 (CC) 的管理可以通过将其分为以下亚型来改进:缓慢过渡便秘,排便障碍和正常过渡便秘.
- 伦敦分类在CC患者中的实用性,通过无线运动囊 (WMC) 和高分辨率门测量 (HR-ARM) 进行评估,被评估为决策.
- 这项研究使用了罗马IV标准来诊断CC,并采用了WMC,HR-ARM,气球驱逐测试和直肠传感测试.
研究的目的:
- 评估伦敦分类在慢性便秘患者中的有用性.
- 检查无线运动囊 (WMC) 和高分辨率门测量 (HR-ARM) 在CC患者的临床决策中的相对实用性.
- 调查结肠直肠功能障碍在CC患者中的患病率,考虑结肠传输时间 (CTT).
主要方法:
- 对166名符合"罗马四号"标准的CC患者前性收集数据的回顾性分析.
- 患者接受了无线运动囊 (WMC) 和高分辨率门测量 (HR-ARM) 的评估.
- 使用WMC (正常<59小时) 确定结肠传输时间 (CTT),并使用伦敦分类分析HR-ARM数据.
主要成果:
- 在166名CC患者中,84人患有正常的CTT,82人患有延长的CTT (>59小时).
- 慢CTT患者年龄较大,疾病持续时间和严重程度较长.
- 在CC患者中观察到高频率的阳门功能障碍,不论是CTT,疾病有显著的重叠.
结论:
- 在慢CTT的患者中,直肠疾病显著重叠,质疑WMC和HR-ARM的特异性.
- 在评估慢性便秘时,WMC和HR-ARM的临床实用性需要进一步验证.
- 需要进行额外的研究,以确定这些诊断工具是可靠的CC标志物和治疗响应.
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