Sex, psychosocial factors, and reported symptoms influence referral for esophagogastroduodenoscopy and biopsy results in children with chronic abdominal pain.
Sex, psychosocial factors, and reported symptoms influence referral for esophagogastroduodenoscopy and biopsy results in children with chronic abdominal pain.
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性别、心理社会因素和报告的症状影响慢性腹痛儿童的食管胃十二指肠镜检查和活检结果转诊。
DOI：
10.1097/mpg.0b013e31815a0a13
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发表时间：
2008
影响因子：
2.9
通讯作者：
Walker,LynnS
中科院分区：
文献类型：
--
作者：
Puzanovova,Martina;Rudzinski,Erin;Shirkey,KeziaC;Cherry,Rebecca;Acra,Sari;Walker,LynnS
目的：确定可预测转诊接受食管胃十二指肠镜检查（EGD）的症状和心理社会因素，并区分活检结果阳性与阴性的患者。患者和方法：8至16岁的儿童和家长完成了评估胃肠道症状和心理社会特征的有效问卷。食管，胃，十二指肠活检结果进行了review.Results：从总样本的461例（平均年龄11.87岁，62%的女孩），127（28%）进行EGD活检（平均年龄12.1岁，57%的女孩）。上腹部消化道症状预测EGD转诊，而心理社会特征没有。在接受EGD的127例患者中，124例患者的完整活检结果可用，34.7%的患者（n= 43）在所有部位均为阴性，20.2%（n= 25）为不确定，45.2%（n= 56）在1个或多个部位为阳性。男生食管活检阳性率（47.2%）高于女生（36.6%）（P< 0.03），男生食管活检阳性率（47.2%）高于女生（26.8%）（P< 0.04）。在男孩中，呕吐（P< 0.02）和家庭压力（P< 0.04）预测食管活检阳性结果。在女孩中，抑郁症状预测阳性活检结果（P= 0.015）。结论：上腹部症状，性别，压力和抑郁症状预测阳性EGD活检结果慢性腹痛患者。有必要研究这些因素与肠道粘膜损伤之间的联系机制。
Objectives:To identify symptoms and psychosocial factors that predicted referral for esophagogastroduodenoscopy (EGD) and discriminated between patients with positive versus negative biopsy findings.Patients and Methods:Children age 8 to 16 years old and parents completed validated questionnaires assessing gastrointestinal symptoms and psychosocial characteristics. Biopsy results of esophagus, stomach, and duodenum were reviewed.Results:From the total sample of 461 patients (mean age 11.87 years, 62% girls), 127 (28%) underwent EGD with biopsy (mean age 12.1 years, 57% girls). Upper abdominal gastrointestinal symptoms predicted EGD referral, and psychosocial characteristics did not. From the total of 127 patients who underwent EGD, complete biopsy results were available for 124 patients and were negative at all sites for 34.7% of patients (n= 43), equivocal for 20.2%(n= 25), and positive at 1 or more sites for 45.2%(n= 56). Boys were more likely than girls to have positive biopsy results (56.6% vs 36.6%, P< 0.03) because of the higher rate of positive esophageal biopsy results (47.2% vs 26.8%, P< 0.04). Among boys, vomiting (P< 0.02) and family stress (P< 0.04) predicted positive esophageal biopsy findings. Among girls, depressive symptoms predicted positive biopsy findings (P= 0.015).Conclusions:Upper abdominal symptoms, sex, stress, and depressive symptoms predict positive EGD biopsy findings in patients with chronic abdominal pain. Research on mechanisms linking these factors to mucosal damage in the gut is warranted.