2025 年第 3 期 第 20 卷

可分离式系线磁控胶囊内镜在伴有粪便潜血试验阳性的心血管疾病患者中的临床应用研究

The clinical application of detachable string magnetically controlled capsule endoscopy in cardiovascular disease patients with positive fecal occult blood test

作者：白国艳孙亚梅闫真陈雪张杰

英文作者：Bai Guoyan Sun Yamei Yan Zhen Chen Xue Zhang Jie

单位：首都医科大学附属北京安贞医院消化内科，北京100029

英文单位：Department of Gastroenterology Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：心血管疾病；可分离式系线磁控胶囊内镜；粪便潜血试验阳性；消化道评估

英文关键词：Cardiovasculardisease;Detachablestringmagneticallycontrolledcapsuleendoscopy;Positivefecaloccultbloodtest;Gastrointestinalassessment

• 摘要：

• 目的 探讨可分离式系线磁控胶囊内镜（ds-MCE）在粪便潜血试验（FOBT）阳性的心血管疾病（CVD）患者中的临床应用价值。方法 回顾性纳入2023年10月至2024年10月于首都医科大学附属北京安贞医院消化科行磁控胶囊内镜检查并伴有FOBT阳性的CVD患者。接受ds-MCE检查的患者作为系线组，接受无线磁控胶囊内镜检查的患者作为无线组。收集2组患者的一般情况、合并症、抗栓药物使用、磁控胶囊内镜的可视化、检出的病变情况以及与检查相关的不适反应和不良事件。主要结局为2组可视化的差异，次要结局为ds-MCE的安全性。结果 最终纳入158例患者，其中系线组53例，无线组105例。系线组食管上段、中段、下段黏膜以及齿状线的4个象限及≥3个象限的可视化率均高于无线组（均P＜0.01）。在胃部可视化方面，系线组患者胃部贲门的可视化率高于无线组（P<0.05）。胃和小肠病变的检出率在2组间差异无统计学意义（P＞0.05）。系线组31例（58.5%）未出现任何不适反应，21例（39.6%）报道了轻度咽部不适，17例（32.1%）报道了轻度恶心，10例（18.9%）报道了轻度咳嗽，1例（1.9%）患者报道了中度恶心，所有的不适反应均可耐受。所有患者均未发生胶囊滞留、胶囊误吸等不良事件。结论 ds-MCE 可以对伴有 FOBT 阳性的 CVD 患者同时完成食管、胃和小肠检查，且安全性良好，可为临床提供准确的诊断依据。

• Objective  To investigate the clinical application value of detachable string magnetically controlled capsule endoscopy (ds-MCE) in patients with a positive fecal occult blood test (FOBT) and underlying cardiovascular disease (CVD). Methods CVD patients with positive FOBT who underwent MCE at the Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University from October 2023 to October 2024 were retrospectively enrolled. The patients who underwent ds-MCE were included in the string group, while those who underwent wireless magnetically controlled capsule endoscopy were included in the wireless group. The general information, complications, antithrombotic drug use, visualization of magnetically controlled capsule endoscopy, detected lesions, adverse reactions and adverse events related to the examination were collected. The primary outcome was the visual difference between the two groups, and the secondary outcome was the safety of ds-MCE. Results Finally, 158 patients were included, including 53 cases in the string group and 105 cases in the wireless group. The visualization rates of the 4 quadrants and ≥3 quadrants for the upper, middle, and lower esophagus, as well as the dentate line, were significantly higher in the string group compared to the wireless group (all P<0.01). In terms of gastric visualization, the visualization rate of gastric cardia in the string group was higher than that in the wireless group (P<0.05). There was no significant difference in the detection rate of gastric and small intestinal lesions between the two groups (P>0.05). In the string group, 31 (58.5%) patients did not experience any discomfort, 21 cases (39.6%) reported mild pharyngeal discomfort, 17 cases (32.1%) reported mild nausea, 10 cases (18.9%) reported mild cough, and 1 case (1.9%) reported moderate nausea, all of which were tolerated. None of the patients had any adverse events such as capsule retention and aspiration etc. Conclusions  The ds-MCE can be used to examine the esophagus, stomach and small intestine simultaneously in CVD patients with positive FOBT. It is safe and can provide accurate evidence for clinical diagnosis.