囊内镜-克罗恩病指数 (CE-CD) 的临床验证和准确性评估
José Vicente Arcos-Machancoses1, Akshay Kapoor2, Dominique Schluckebier2
1Department of Paediatric Gastroenterology, Hepatology and Nutrition, Hospital Clínic Universitari de València, València, Spain.
新的囊内镜-克罗恩病指数 (CE-CD) 准确地测量了儿科克罗恩病 (CD) 中小肠炎症. 它预测了治疗升级,并显示了观察者之间强烈的共识.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 诊断工具开发 诊断工具开发
背景情况:
- 儿童的克罗恩病 (CD) 需要对小肠炎症 (SB) 的准确评估.
- 现有的囊内镜 (CE) 评分系统在预测临床结果方面存在局限性.
- 一个新的指数CE-CD已被提出,以改善SB炎症评估.
研究的目的:
- 为了评估CE-CD指数的精度和准确性.
- 将CE-CD与已建立的CE评分方法进行比较.
- 确定CE-CD能够预测儿科CD的不良临床结果的能力.
主要方法:
- 对接受CE的儿科CD患者的回顾性分析,随访时间≥1年.
- 两个儿科胃肠科医生使用CE-CD和其他指数对CE研究进行了独立评分.
- 统计分析包括线性回归,ROC曲线,生存分析和Cox回归.
- 对CE-CD.的观察者间协议的评估.
主要成果:
- CE-CD与易斯评分 (ρ=0.947) 和CECDAI (ρ=0.982) 有很强的相关性.
- 无论是CE-CD还是CECDAI,都预测了治疗升级 (p<0.01).
- 一个CE-CD得分≥9表示中度至重度的SB炎症,预测治疗升级 (HR 2.6) 具有48.4%的灵敏度和89.3%的特异性.
- 没有得分预测住院,手术或复发.
- 对于CE-CD,观察者之间的完全一致性 (kappa 100%) 被观察到.
结论:
- CE-CD是一种可靠的工具,用于记录儿科CD中的SB炎症.
- CE-CD显示与现有分数有很强的相关性.
- 与其他指数相比,CE-CD显示了治疗升级的优越预测.
- 该指数表现出了卓越的观察者间一致性,促进了一致的临床应用.
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