活动性克罗恩病的泛肠道克罗恩囊(Eliakim)评分可靠性和对变化的反应性。

Offir Ukashi, Adi Lahat, Bella Ungar, Hadar Levy, Orel Finkel, Pinhas Eidler, Shomron Ben-Horin, Rami Eliakim, Uri Kopylov
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引用次数: 0

摘要

背景和目的:泛肠道胶囊内镜(PillCam 克罗恩氏胶囊 [PCC])是诊断和监测克罗恩病(CD)的有效工具。在静止期克罗恩病中使用 PCC 已证明了 Eliakim 评分 [ES] 的可靠性以及与 Lewis 评分 (LS) 和炎症生物标志物的强相关性。我们的目的是研究 ES 在活动性 CD 中的表现及其随着时间推移对临床/生化变化的反应能力:方法:纳入已开始使用生物制剂的 CD 患者,对其进行前瞻性随访,包括基线、14 周和 52 周后的临床访视、生物标志物和 PCC。收集克罗恩病活动指数(CDAI)、C反应蛋白(CRP)和粪便清蛋白(FC)水平,计算LS和ES(由两名经验丰富的读者独立审核)。进行了类间分类(ICC)、斯皮尔曼基线相关性和重复测量相关性(RMC)分析:共纳入 74 名患者(年龄:30.5 [23.3-45.0] 岁,男性占 50%)。阅读了 142 份 PCC(基线-62、第 14 周-58、第 52 周-22)。LS 和 ES 的评分者之间的一致性很高(ICC:0.872[p结论:ES 是评估活动性 CD 全肠道粘膜炎症的可靠评分系统,与 LS 相比,ES 对随时间推移的临床/生化变化的反应更灵敏。
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Pan-Enteric Crohn's Capsule [Eliakim] Score Reliability and Responsiveness to Change in Active Crohn's Disease.

Background and aims: Pan-enteric capsule endoscopy (PillCam Crohn's capsule [PCC]) is a useful tool in diagnosing and monitoring Crohn's disease [CD]. Eliakim score [ES] reliability and its strong correlation to Lewis score [LS] and to inflammatory biomarkers have been previously demonstrated using PCC in quiescent CD. We aimed to examine ES performance in active CD and its responsiveness to clinical/biochemical change over time.

Methods: Patients with CD who have started biologics were included, and were prospectively followed based on clinical visits, biomarkers, and PCC at baseline, after 14 and 52 weeks. Crohn's disease activity index [CDAI], C-reactive protein [CRP], and faecal calprotectin [FC] levels were determined, and LS and ES were calculated [independently reviewed by two experienced readers]. Inter-class classification [ICC], Spearman's baseline correlation, and repeated-measures correlation [RMC] analyses were performed.

Results: Seventy-four patients were included (age: 30.5 [range 23.3-45.0] years old, male 50%). In total, 142 PCCs were read [baseline, 62; week 14, 58; week 52, 22]. Inter-rater agreement was high for both LS and ES (ICC: 0.872 [p < 0.001] and 0.925 [<0.001], respectively). Baseline correlations between FC&ES [r = 0.509 [p < 0.001]) and FC&LS (r = 0.467 [p < 0.001]) were comparable [p = 0.56]. RMCs between the inflammatory biomarkers and ES were higher than between the former and LS (Reader 1: CRP r = 0.306 vs r = 0.138 [p = 0.057], FC r = 0.479 vs r = 0.297 [p = 0.034]; Reader 2 CRP r = 0.376 vs r = 0.204 [p = 0.035], FC r = 0.549 vs r = 0.412 [p = 0.075]). Moreover, ES was better correlated to CDAI than LS [p = 0.036].

Conclusions: ES is a reliable scoring system in assessing pan-enteric mucosal inflammation in active CD, and might have a better responsiveness to clinical/biochemical change over time compared to LS.

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