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芝加哥分类版本4.0改善了无效食道运动患者的分层,将其分为临床上有意义的亚型:一项两中心国际研究
Moshe Carmel1,2, Daniel L Cohen3, Basem Hijazi4
1Azrieli Faculty of Medicine, Bar Ilan University, Ramat Gan, Israel. mocarmel@gmail.com.
Dysphagia
|November 7, 2023
概括
对食道运动障碍的更新的芝加哥分类v4.0限制了无效食道运动 (IEM) 诊断. 在v4.0以下的IEM患者显示食道功能较差和酸暴露较高,表明临床上更相关的患者群体.
科学领域:
- 胃肠病学 胃肠病学
- 食道生理学 食道生理学
- 诊断标准 诊断标准 诊断标准
背景情况:
- 芝加哥分类 (CC) 为食道运动障碍提供了标准化的标准.
- 与CC v3.0.0相比,CC v4.0为无效食道运动 (IEM) 引入了更具限制性的标准.
- 了解这些更新的标准的影响对于准确的诊断和患者管理至关重要.
研究的目的:
- 为了比较CC v3.0下被诊断为IEM的,CC v4.0下被重新归类为正常的患者与保留IEM诊断的患者.
- 评估这些群体之间的临床和测量差异.
- 评估新CC v4.0标准对IEM诊断的影响.
主要方法:
- 追溯病例对照研究分析了2020-2021年高分辨率测力仪 (HRM) 数据.
- 重新分析了最初在CC v3.0下使用CC v4.0标准诊断IEM的研究.
- 在不同组之间比较人口统计,临床数据,计量力和pH监测参数.
主要成果:
- 在154个CC v3.0 IEM案例中,39个 (25%) 被CC v4.0.0重新归类为正常.
- 与CC v4.0 IEM组相比,CC v4.0正常组表现出更好的收缩恢复和更短的酸暴露时间.
- CC v4.0发现了较少的IEM患者,确定了 significantly更糟糕的食道功能和更高的酸负担的队列.
结论:
- 对IEM的CC v4.0标准比CC v3.0.0标准更为严格.
- 更新的标准成功地确定了一组IEM患者的亚组,这些患者表现出更严重的食道功能障碍和更高的酸暴露.
- CC v4.0可能会将IEM诊断改进到更具临床意义的人群中,这需要进一步调查.
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