通过硒-75-高胆酸牛磺酸(75SeHCAT)扫描检查胆汁酸吸收不良,这是一项回顾性单中心经验。

IF 1.3 4区 医学 Q4 GASTROENTEROLOGY & HEPATOLOGY Acta gastro-enterologica Belgica Pub Date : 2024-07-01 DOI:10.51821/87.3.13036
F Vulsteke, R De Gersem, J Arts, T Vanuytsel
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引用次数: 0

摘要

背景:胆汁酸吸收不良(BAM)是慢性水样腹泻患者的常见症状。然而,文献表明胆汁酸吸收不良诊断不足,治疗不足。在许多国家,75SeHCAT 是诊断 BAM 的金标准(1-5)。这项回顾性研究的目的是通过 75SeHCAT 闪烁成像检查 BAM 的发病率以及对胆汁酸螯合剂治疗的反应:我们回顾性评估了 2016 年 1 月至 2023 年 1 月期间接受 75SeHCAT 扫描的 420 名患者的临床数据。对电子病历进行了调查,以了解 BAM 的风险因素。BAM定义为75SeHCAT保留率低于15%。根据门诊临床报告评估对胆汁酸螯合剂的反应:进行 75SeHCAT 检测时的中位年龄为 47 岁(14-87 岁不等)。在 420 名患者中,192 人(46%)的 BAM 结果呈阳性。胆囊切除术和回肠切除术是预测 BAM 的重要因素(p结论:这项对接受 SeHCAT 扫描的患者进行的回顾性研究证实,在二级医疗机构就诊的耐药慢性腹泻患者中,约有三分之一患有 BAM。将该检测纳入慢性腹泻的临床治疗方案中,可以对 BAM 进行早期定量诊断和治疗。
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Bile acid malabsorption investigated by selenium-75-homocholic acid taurine (75SeHCAT) scans, a retrospective single-centre experience.

Background: Bile acid malabsorption (BAM) is a common entity in patients experiencing chronic watery diarrhea. However, literature suggests that BAM is underdiagnosed and undertreated. In many countries 75SeHCAT is the gold standard for diagnosing BAM (1-5). The aim of this retrospective study was to investigate the frequency of BAM using 75SeHCAT scintigraphy and the response to treatment with bile acid sequestrants.

Methods: We retrospectively evaluated the clinical data of 420 patients who had a 75SeHCAT scan from January 2016 to January 2023. Electronic medical records were investigated for risk factors of BAM. BAM was defined as a 75SeHCAT retention of less than 15%. Response to bile acid sequestrants was evaluated based on outpatient clinical reports.

Results: Median age at the time of 75SeHCAT test was 47 years (range 14-87). Out of 420 patients, 192 (46%) had a positive result for BAM. Cholecystectomy and ileal resection were significant predictors for BAM (p<0.001). BAM type 1 is statistically more likely to be more severe compared to type 2 (p<0.0001) and compared to type 3 (p=0.0021). In patients who fulfilled Rome IV criteria for IBS-D or functional diarrhea, 75 out of 121 (38%) tested positive for BAM. Overall, treatment with bile acid binders was effective in 76%.

Conclusions: This retrospective study of patients who underwent SeHCAT scanning confirms that about 1/3 patients presenting with therapy-resistant chronic diarrhea in secondary care suffer from BAM. Including the test in clinical management protocols of chronic diarrhea allows early and quantitative diagnosis and treatment of BAM.

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来源期刊
Acta gastro-enterologica Belgica
Acta gastro-enterologica Belgica Medicine-Gastroenterology
CiteScore
2.30
自引率
20.00%
发文量
78
期刊介绍: The Journal Acta Gastro-Enterologica Belgica principally publishes peer-reviewed original manuscripts, reviews, letters to editors, book reviews and guidelines in the field of clinical Gastroenterology and Hepatology, including digestive oncology, digestive pathology, as well as nutrition. Pure animal or in vitro work will not be considered for publication in the Journal. Translational research papers (including sections of animal or in vitro work) are considered by the Journal if they have a clear relationship to or relevance for clinical hepato-gastroenterology (screening, disease mechanisms and/or new therapies). Case reports and clinical images will be accepted if they represent an important contribution to the description, the pathogenesis or the treatment of a specific gastroenterology or liver problem. The language of the Journal is English. Papers from any country will be considered for publication. Manuscripts submitted to the Journal should not have been published previously (in English or any other language), nor should they be under consideration for publication elsewhere. Unsolicited papers are peer-reviewed before it is decided whether they should be accepted, rejected, or returned for revision. Manuscripts that do not meet the presentation criteria (as indicated below) will be returned to the authors. Papers that go too far beyond the scope of the journal will be also returned to the authors by the editorial board generally within 2 weeks. The Journal reserves the right to edit the language of papers accepted for publication for clarity and correctness, and to make formal changes to ensure compliance with AGEB’s style. Authors have the opportunity to review such changes in the proofs.
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