在PREVENT试验中评估克罗恩病术后复发的内镜指数的可靠性和响应性
Jurij Hanzel1, Sudheer K Vuyyuru2, Brian Bressler3
1Department of Gastroenterology, UMC Ljubljana, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia; Alimentiv Inc, London, Ontario, Canada.
概括
内镜评分工具可靠地评估术后的克罗恩病活动. 然而,它们的可靠性和响应性对于评估解肠或偏肠是不理想的.
科学领域:
- 胃肠病学
- 临床内镜
- 炎症性肠病研究
背景情况:
- 对内镜活动的准确评估对于术后克罗恩病 (CD) 的管理至关重要.
- 存在各种内镜评分系统,但它们在术后的比较性能需要彻底评估.
- PREVENT试验为评估这些仪器提供了有价值的数据.
研究的目的:
- 综合评估多种内镜仪器的可靠性和响应性,以评估术后的CD活动.
- 在特定的解剖部位比较不同评分系统的性能:新末端结膜,解剖结膜和远端结肠.
主要方法:
- 在PREVENT试验中,三名盲人读者查看了70名患者的胆结肠镜视频.
- 使用Rutgeerts,修改的Rutgeerts,POCER指数,REMIND得分,SES-CD和CDEIS进行了疾病活动评估.
- 可靠性是通过类内相关系数 (ICC) 测量;响应性是通过获胜概率 (WinP) 测量.
主要成果:
- 在Rutgeerts,修饰的Rutgeerts,状REMIND,SES-CD和CDEIS中发现了实质性的评价者间可靠性 (ICC 0.74- 0.80) 和高响应率 (WinP 0.75- 0.83).
- 对于POCER和RAMIND,观察到中等 (POCER指数) 到相当 (解剖学 REMIND) 的可靠性和较小的响应性.
- 与新末端大肠相比,对解肠和远端大肠的可靠性和响应性估计始终较低.
结论:
- 已确立的内镜指数表明,在新末端膜中评估术后克罗恩病的可靠性和响应性很好.
- 这些指数对于评估位或远端结肠的疾病活性是不理想的.
- 对于这些特定的术后段,可能需要进一步完善内镜评估工具.
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