Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease.
Practice patterns and clinical significance of use of capsule endoscopy in suspected and established Crohn's disease.
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DOI：
10.5217/ir.2017.15.4.467
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发表时间：
2017-10
影响因子：
4.9
通讯作者：
Lee MS
中科院分区：
文献类型：
--
作者：
Kim Y;Jeon SR;Choi SM;Kim HG;Lee TH;Cho JH;Jung Y;Kim WJ;Ko BM;Kim JO;Lee JS;Lee MS
尽管胶囊式内窥镜（CE）在克罗恩病（CD）中的作用已经扩大，但在韩国，CE并不常规用于诊断和评价CD。我们的目的是调查目前的实践模式，并评价在韩国患者中使用CE治疗CD的临床意义。在因各种适应症进行的651例CE手术中，我们回顾性分析了57例疑似CD（sCD）和14例确诊CD（eCD）患者接受CE的病历。在sCD组中，CE最常用于CD的初始诊断（54.4%）。在eCD组中仅1例患者（1/71，1.4%）发现胶囊滞留。在sCD组中，28.1%的患者根据CE结果诊断为CD;诊断的其他疾病包括结核性肠炎（7.0%）、非甾体抗炎药诱导的肠病（5.3%）和其他肠炎（17.5%）。只有11.5%的eCD患者（14/122）接受了CE检查。14例eCD患者的CE适应症是评估疾病程度和活动性。CE的总诊断率为59.7%。根据CE结果，sCD组70.2%的患者和eCD组50%的患者改变了治疗策略。在临床实践中，CE最常用于CD的初步诊断，通常不用于eCD患者。CE似乎是评估sCD的有效诊断方式，并可用于确定sCD患者和eCD患者的治疗策略。
Although the role of capsule endoscopy (CE) in Crohn's disease (CD) has expanded, CE is not used routinely for diagnosing and evaluating CD in Korea. We aimed to investigate current patterns of practice and evaluate the clinical significance of the use of CE in CD in Korean patients. Among 651 CE procedures performed for various indications, we retrospectively analyzed the medical records of patients who underwent CE in 57 cases of suspected CD (sCD) and 14 cases of established CD (eCD). In the sCD group, CE was most commonly used for the initial diagnosis of CD (54.4%). Capsule retention was found in only 1 patient in the eCD group (1/71, 1.4%). In the sCD group, 28.1% of patients were diagnosed with CD on the basis of CE findings; other diseases diagnosed included tuberculous enteritis (7.0%), non-steroidal anti-inflammatory drug-induced enteropathy (5.3%), and other enteritis (17.5%). Only 11.5% of patients with eCD (14/122) underwent CE. The indication for CE in the 14 patients with eCD was to assess disease extent and activity. The overall diagnostic yield of CE was 59.7%. Therapeutic strategies were changed in 70.2% of patients in the sCD group and 50% of those in the eCD group based on CE findings. In clinical practice, CE was most commonly indicated for the initial diagnosis of CD and was not generally performed in patients with eCD. CE appears to be an effective diagnostic modality for evaluating sCD and is useful for determining therapeutic strategies for patients with sCD and those with eCD.