点护理超声提供了有用的信息,儿童克罗恩病访问门诊诊所。

IF 2.6 3区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Elsa A van Wassenaer, Angelika Kindermann, Tim G J de Meij, Johan E van Limbergen, Geert R D'Haens, Marc A Benninga, Bart G P Koot
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引用次数: 0

摘要

目的:点护理超声(POCUS)越来越多地应用于临床实践。然而,在儿童克罗恩病(CD)中,它与常规疾病活动标志物的附加价值尚未得到研究。本研究旨在评估POCUS在CD患儿中的临床附加价值。方法:前瞻性纳入连续门诊就诊的CD患儿,在进行POCUS的同时进行粪钙保护蛋白(FC)试验和儿科克罗恩病粘膜炎症无创指数(MINI-index)评估。两项测试均分为正常、不确定和异常。儿科胃肠病学家决定POCUS披露前后的临床处理。评估POCUS对4个月内临床发作的预测价值。结果包括POCUS结果与FC和mini指数不一致的患者比例(95% CI), POCUS改变临床管理的患者比例,以及POCUS对临床疾病发作的预测价值。结果:我们纳入76例患者(中位年龄:16岁,女性34例(45%),中位病程:2年)。在7例(9%(4%-18%))和2例(3%(0%-9%))患者中,POCUS导致较轻的疾病严重程度分类,43例(57%(45%-70%))和44例(58%(46%-69%))患者的疾病严重程度分类分别比FC和MINI-index更严重。46例(58%)POCUS结果披露后调整了临床管理。异常POCUS 4个月内临床发作的阳性预测值为71%(57% ~ 82%),阴性预测值为74%(64% ~ 83%)。结论:POCUS似乎是一种有价值的无创监测工具,我们的研究结果支持POCUS在这些儿童的临床管理中的应用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Point-of-care ultrasound provides useful information in children with Crohn's disease visiting the outpatient clinic.

Point-of-care ultrasound provides useful information in children with Crohn's disease visiting the outpatient clinic.

Objectives: Point-of-care ultrasound (POCUS) is increasingly used in clinical practice. However, it's additional value next to conventional markers of disease activity has not been studied in paediatric Crohn's disease (CD). This study aimed to assess the clinical added value of POCUS in children with CD.

Methods: Consecutive children with CD visiting the outpatient clinic were prospectively enrolled and underwent POCUS in addition to faecal calprotectin (FC) test and mucosal inflammation noninvasive index for paediatric Crohn's disease (MINI-index) assessment. Both tests were categorised into normal, uncertain and abnormal. Paediatric gastroenterologists decided on clinical management before and after POCUS disclosure. Predictive value of POCUS for clinical flares within 4 months was assessed. Outcomes were the proportion (95% CI) of patients where POCUS result was discordant from FC and MINI-index, proportion of patients where POCUS changed clinical management, and predictive values of POCUS for clinical disease flares.

Results: We included 76 patients (median age: 16 years, 34 (45%) female, median disease duration: 2 years). In 7 (9% (4%-18%)), and 2 (3% (0%-9%)) patients, the POCUS resulted in a less severe classification and in 43 (57% (45%-70%)), and 44 (58% (46%-69%)), in a more severe classification of disease severity compared to FC and MINI-index, respectively. Clinical management was adjusted in 46 (58%) cases after POCUS result disclosure. The positive and negative predictive value for clinical flares within 4 months of an abnormal POCUS were 71 (57%-82)% and 74 (64%-83)%, respectively.

Conclusions: POCUS seems a valuable noninvasive monitoring tool for children with CD. Our results support the application of POCUS in the clinical management of these children.

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来源期刊
CiteScore
5.30
自引率
13.80%
发文量
467
审稿时长
3-6 weeks
期刊介绍: ​The Journal of Pediatric Gastroenterology and Nutrition (JPGN) provides a forum for original papers and reviews dealing with pediatric gastroenterology and nutrition, including normal and abnormal functions of the alimentary tract and its associated organs, including the salivary glands, pancreas, gallbladder, and liver. Particular emphasis is on development and its relation to infant and childhood nutrition.
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