2018 年第 3 期 第 13 卷

磁控胶囊内镜在服用阿司匹林肠溶片患者胃和小肠黏膜损伤诊断中的临床应用价值

Application value of magnetic-controlled capsule endoscopy in diagnosis of gastric and small intestinal mucosal injuries in patients taking enteric-coated aspirin

作者：高峰张杰郎海波石进陈雪闫真孙玥

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单位：100029首都医科大学附属北京安贞医院消化内科

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• 摘要：

• 目的    探讨磁控胶囊内镜在服用阿司匹林肠溶片患者胃和小肠黏膜损伤诊断中的临床应用价值。方法    2017年9—11月招募在首都医科大学附属北京安贞医院就诊的服用阿司匹林肠溶片>3个月且无消化道症状的患者（15例）以及健康志愿者（20例），行磁控胶囊内镜检查。对比观察2组间胃和小肠黏膜损伤Lanza评分、相关时间指标，观察磁控胶囊内镜排出率和耐受性。结果    服用阿司匹林患者胃、小肠黏膜损伤Lanza评分高于健康志愿者［4（3，4）分比1（0，2）分、1（1，2）分比0（0，0）分］，差异有统计学意义（P<0.05）。2组胃检查时间、小肠通过时间、胶囊内镜排出时间差异无统计学意义（P>0.05）。35例受试者均顺利完成磁控胶囊内镜检查，胶囊均顺利排出，排出率为100%。大多数受试者20～48 h排出胶囊，1例受试者120 h排出胶囊。完全耐受磁控胶囊内镜检查33例（94.3%），出现轻度不适2例(5.7%)，不良反应均在24 h内自行缓解。结论    无消化道症状的服用阿司匹林肠溶片患者较健康志愿者胃和小肠黏膜损伤明显增加。磁控胶囊内镜检查无创且不用停用阿司匹林，可用于正在服用阿司匹林患者胃和小肠黏膜损伤的实时观察。

• Objective    To investigate the application value of magnetic-controlled capsule endoscopy in diagnosis of gastric and small intestinal mucosal injuries in patients taking enteric-coated aspirin. Methods    Fifteen patients who had taken enteric-coated aspirin without gastrointestinal symptom for more than 3 months and 20 healthy volunteers were enrolled from September to November 2017 in Beijing Anzhen Hospital, Capital Medical University to have magnetic-controlled capsule endoscopy. The Lanza score of gastric and small intestinal mucosal injuries, time indexes of endoscopy, excretion rate and tolerance of magnetic-controlled capsule were analyzed. Results    The Lanza scores of gastric and small intestinal mucosa injuries in patients taking aspirin were significantly higher than those in healthy people［4（3，4）points vs 1（0，2）points, 1（1，2）points vs 0（0，0）points］（P<0.05）. There was no significant differences of gastric examination time, small intestinal passing time and capsule excretion time between groups(P>0.05). All of 35 subjects successfully completed magnetic-controlled capsule endoscopy, and the capsule excretion rate was 100%. Most of them excreted the capsule in 20-48 h; 1 case excreted the capsule in 120 h. Thirty-three（94.3%） of them were fully tolerated by magnetic-controlled capsule endoscopy; 2 cases had mild discomforts which were relieved in 24 h. Conclusions    Patients taking enteric-coated aspirin without gastrointestinal symptom may suffer from more gastric and small intestinal mucosal injuries than healthy people. Noninvasive magnetic-controlled capsule endoscopy can be used for real time observation of gastric and small intestinal mucous injuries in patients taking aspirin.