基于结肠过境试验的便秘患者功能性排泄障碍的鉴定:一项追溯性研究
Xiaoyang Ren1, Xiaoni Yan1, Jiao Zhu1
1Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Scandinavian journal of gastroenterology
|November 28, 2024
概括
结肠过境检测 (CTT) 显示,在中国患者中,功能性排便障碍 (FDD) 的诊断值为中等. 高特异性但低灵敏性表明,CTT更好地排除FDD,而不是确认它.
科学领域:
- 胃肠病学 胃肠病学
- 诊断成像 诊断成像 诊断成像
- 功能性肠道疾病 功能性肠道疾病
背景情况:
- 便秘是一种常见的疾病,通常与功能性排便障碍 (FDD) 相关.
- 准确诊断FDD对于有效管理至关重要.
- 对于FDD的结肠过渡试验 (CTT) 的诊断实用性需要进一步评估,特别是在多样化的群体中.
研究的目的:
- 评估结肠过渡试验 (CTT) 的诊断效果,以确定功能便障碍 (FDD) 在中国患有便秘的患者中.
- 评估区分FDD与其他类型便秘的症状特征.
- 为了确定CTT参数的诊断值,包括直筒形状体 (RS) 残留标记和过境指数,用于FDD.
主要方法:
- 对202名功能性便秘患者的回顾性分析.
- 患者接受了结肠过渡测试 (CTT),高分辨率直肠测量和气球驱逐测试.
- 根据罗马四号标准对FDD (103名患者) 和非FDD (99名患者) 患者进行分类.
主要成果:
- 过度劳累是最常见的症状 (69.3%).
- 与非FDD组相比,FDD组的硬便和不完全疏散的发生率显著更高.
- 脊柱状体 (RS) 残留标记 (≥3) 和过渡指数 (≥40%) 对FDD具有中等的诊断价值 (低敏感度,高特异性),有效地将FDD与正常过渡便秘区分开来,但不是缓慢过渡便秘.
结论:
- 脊柱状体 (RS) 残留物主要是FDD诊断的排除标准.
- 在缓慢过渡性便秘中,需要多次动力学评估来区分FDD与其他类型的便秘.
- CTT在评估便秘方面发挥着作用,但需要进一步的研究,以在特定的过境模式中准确诊断FDD.
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