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在高分辨率食道测量中使用挑性测试来评估阿卡拉西亚的诊断产量:连续诊断研究
Humayra Dervin1, James Endersby1, Santosh Sanagapalli1,2
1GI Physiology Unit, University College London, London, UK.
Neurogastroenterology and motility
|October 17, 2023
概括
在阿喀拉西亚诊断中,挑性测试可以揭示单水吞 (SWS) 没有出现的测量力变化和症状,特别是在I型和II型阿喀拉西亚中. 这种个性化的方法指导了阿喀拉西亚患者的有效治疗决策.
科学领域:
- 胃肠病学 胃肠病学
- 食道运动障碍 食道运动障碍
- 诊断成像 诊断成像 诊断成像
背景情况:
- 芝加哥分类v4.0表明,如果在单个水吞 (SWS) 上表现出阿喀拉西亚,则不需要挑性测试.
- 这项研究调查了挑性测试是否会改变人测结果,并在疑似阿喀拉西亚病例中重现症状.
研究的目的:
- 评估挑性测试对阿喀拉西亚高分辨率测量 (HRM) 结果的影响.
- 为了确定挑性测试是否可以揭示或澄清阿喀拉西亚诊断,并重现患者的症状.
- 评估挑性测试在指导个性化阿喀拉西亚治疗中的作用.
主要方法:
- 在2016-2022年期间,对127名接受HRM的阿喀拉西亚患者进行了回顾性分析.
- 所有患者都完成了SWS,许多人还接受了固体食 (SM) 和/或快速饮料挑战 (RDC).
- 收集的数据包括人口统计,光镜,胃镜和埃卡德得分.
主要成果:
- 挑性测试显示,15.4%的患者在SWS上具有正常的综合放松压力 (IRP) 时出现了阻塞.
- 固体食物在44.9%的患者中改变了阿喀拉西亚表型.
- 第三种类型的阿喀拉西亚患者在挑性测试中没有显示变化Manometric发现;在SM期间,症状在56.7%的患者中重现.
- 在44.7%的患者中,挑性测试结果影响了治疗决策,导致有效的治疗方法.
结论:
- 挑性测试是有价值的澄清阿喀拉西亚诊断 (类型I和II),当SWS发现是正常的或模两可.
- 它可以改变尺度表现型,发现阻塞,并重现症状,有助于个性化治疗.
- 对于III类型的阿喀拉西亚,SWS是足够的,挑性测试不会改变尺度检测结果.
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