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Caroline R Meijer-Boekel¹, Lucy Smit², M Elske van den Akker-van Marle³

¹Department of Pediatric Gastroenterology, Leiden University Medical Center, Willem Alexander Children's Hospital, Leiden, the Netherlands.

|May 6, 2025

概括

在荷兰预防性青年保健中心 (YHCCs) 实施幼儿患乳病 (CD) 病例发现是有效的. 与标准护理相比,这种方法显著增加了早期CD诊断,改善了儿童健康结果.

科学领域:

儿科胃肠病学儿科胃肠病学
公共卫生公共卫生
预防医学预防医学

背景情况:

结核病 (CD) 经常被低诊断,导致严重的健康并发症和增加的医疗负担.
早期诊断和治疗CD对于减轻长期发病率和死亡率至关重要.

研究的目的:

为了前性地评估在幼儿中患有乳病的病例发现策略的可行性和有效性.
评估在预防性青年卫生保健机构内对乳性疾病自身抗体的临床检测的诊断收益率.

主要方法:

一项前性研究涉及1至4岁的儿童,他们在2019年2月至2022年1月期间参加荷兰预防性青年医疗保健中心 (YHCCs).
在患有至少一种CD相关症状的儿童中,进行了治疗地点检测胆固醇自身抗体 (TGA-IgA/IgG/IgM) 的测试.
诊断确认涉及TGA-IgA水平升高或特定的组织病理学发现以及阳性自身抗体.

主要成果:

在14917名参与的家长中,35.5%报告了症状. 病例发现确定了56名儿童的确诊CD (1.7%),平均年龄为2.6岁.
通过病例发现诊断的CD发病率为1.67/1000人年,明显高于标准护理率0.14/1000人年 (P < .001).
腹部膨胀是CD儿童中明显更频繁的唯一症状.

结论:

在荷兰的预防性YHCC中,使用临床检测发现患有乳病的病例既有效又可行.
将这种发现病例的策略整合到日常护理中,可以促进儿童及时诊断乳病.

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