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【文摘发布】胶囊内镜诊断遗传性出血性毛细血
Author: Chamberlain SM, Patel J, Carter Balart J, Gossage JR, Sridhar S.
Resource: Endoscopy. 2007 Jun;39:516-20.
Abstract:BACKGROUND AND STUDY AIMS: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by telangiectasia formation that can lead to small-bowel bleeding. In this study, video capsule endoscopy was used to compare the small-bowel findings observed in patients with HHT with those seen in patients without the condition. PATIENTS AND METHODS: We performed capsule endoscopy studies in 93 consecutive patients who were being evaluated for small-bowel bleeding, 38 patients with known or suspected HHT and 55 patients without HHT. Nine patients were excluded because the capsule failed to reach the cecum. The findings in 32 patients with a final diagnosis of HHT and in 48 patients without HHT were recorded and compared. RESULTS: Capsule endoscopy detected telangiectases evenly distributed throughout the small bowel in 26/32 (81%) patients with HHT, compared with 14/48 (29%) in patients without HHT. When active bleeding was observed in patients with HHT (n = 4), the bleeding was within reach of standard small-bowel push enteroscopy in all cases. The presence of five or more gastrointestinal telangiectases by capsule endoscopy had a sensitivity of 75% and a positive predictive value of 86% for diagnosing HHT. Unexpected findings (small-bowel polyps and mass-like lesions) were seen in both groups of patients (6.2% in patients with HHT and 2.1% in patients without HHT). CONCLUSIONS: Small-bowel telangiectases were seen in the majority of patients with HHT and were evenly distributed throughout the small bowel. Telangiectases were observed in only a minority of patients who did not have HHT. Actively bleeding small-bowel telangiectases were located in the proximal and mid-small bowel in patients with HHT, all within reach of an enteroscope. We propose a cutoff point of at least five gastrointestinal telangiectases to support a diagnosis of HHT.
PMID: 17554646 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Title: Evaluation of patients with hereditary hemorrhagic telangiectasia with video capsule endoscopy: a single-center prospective study.
题目：单中心前瞻性研究影像胶囊内镜检查对遗传性出血性毛细血管扩张症患者的评估
Author: Chamberlain SM, Patel J, Carter Balart J, Gossage JR, Sridhar S.
Resource: Endoscopy. 2007 Jun;39:516-20.
来源：内窥镜检查 2007 6 39 ：516-20
Abstract:BACKGROUND AND STUDY AIMS: Hereditary hemorrhagic telangiectasia (HHT) is a rare autosomal dominant disorder characterized by telangiectasia formation that can lead to small-bowel bleeding. In this study, video capsule endoscopy was used to compare the small-bowel findings observed in patients with HHT with those seen in patients without the condition.
摘要 背景与研究目的：遗传性出血性毛细血管扩张症(HHT)为罕见的常染色体显性疾病，其特征为小肠毛细血管扩张、出血。在本研究中，比较影像胶囊内镜检查遗传性出血性毛细血管扩张症患者和不伴有此病患者检查所见。
PATIENTS AND METHODS: We performed capsule endoscopy studies in 93 consecutive patients who were being evaluated for small-bowel bleeding, 38 patients with known or suspected HHT and 55 patients without HHT. Nine patients were excluded because the capsule failed to reach the cecum. The findings in 32 patients with a final diagnosis of HHT and in 48 patients without HHT were recorded and compared.
患者和方法：93例连续的小肠出血患者给予影像胶囊内镜检查，38例患者为确诊或可疑遗传性出血性毛细血管扩张症，55例不患此病。9例患者因检查时胶囊不能到达小肠末端（盲肠）被除外。32例确诊为遗传性出血性毛细血管扩张症患者和48例非遗传性出血性毛细血管扩张症患者纳入对比分析。
RESULTS: Capsule endoscopy detected telangiectases evenly distributed throughout the small bowel in 26/32 (81%) patients with HHT, compared with 14/48 (29%) in patients without HHT. When active bleeding was observed in patients with HHT (n = 4), the bleeding was within reach of standard small-bowel push enteroscopy in all cases. The presence of five or more gastrointestinal telangiectases by capsule endoscopy had a sensitivity of 75% and a positive predictive value of 86% for diagnosing HHT. Unexpected findings (small-bowel polyps and mass-like lesions) were seen in both groups of patients (6.2% in patients with HHT and 2.1% in patients without HHT).
结果：影像胶囊内镜检查发现在32例HHT患者有26例（81%）患者毛细血管扩张平衡分布于整个小肠，在48例非遗传性出血性毛细血管扩张症患者有16例；发现4例HHT患者活动性出血，标准小肠肠镜均可到达出血部位。利用胶囊内镜检查5处或更多处胃肠道毛细血管扩张诊断为HHT，敏感性75%，阳性预测值为86%，两组患者检查中均有意外发现（小肠息肉和类似肿块损害）（HHT组发现率为6.2%，非HHT组为2.1%）
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作者:admin@医学,生命科学 2011-03-13 17:11
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