2025 年第 12 期 第 20 卷

磁控胶囊内镜检查在抗栓治疗患者中的临床应用价值研究

Study on the clinical application value of magnetically controlled capsule endoscopy in patients with antithrombotic therapy

作者：刘莹高峰张杰

英文作者：Liu Ying Gao Feng 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：抗栓治疗；磁控胶囊内镜；消化道评估

英文关键词：Antithrombotictherapy;Magneticallycontrolledcapsuleendoscopy;Digestivetractassessment

• 摘要：

• 目的 探讨磁控胶囊内镜在抗栓治疗患者中的临床应用价值。方法 收集2019年1月至2023年12月在首都医科大学附属北京安贞医院消化内科就诊并行磁控胶囊内镜检查的1 215例患者的临床资料进行回顾性分析。根据患者是否服用抗栓治疗药物将患者分为抗栓治疗组（413例）和对照组（802例，未使用抗栓治疗药物）。比较2组间及其中胃肠道出血患者间的一般资料、内镜检查结果。结果 抗栓治疗组胃肠道出血比例显著高于对照组［49.4%（204/413）比6.1%（49/802）］，其中显性出血、隐性出血比例均高于对照组（均P<0.001）。抗栓治疗组胃溃疡、小肠溃疡、空回肠溃疡比例、胃黏膜损伤改良Lanza评分和小肠黏膜损伤分级评分明显高于对照组（均P<0.05）。胃肠道出血患者抗栓治疗组小肠出血比例、胃黏膜损伤Lanza评分和小肠黏膜损伤分级评分明显高于对照组［52.0%（106/204）比18.4%（9/49）、2.0(1.0，4.0)分比1.0(1.0，2.0)分、2.0(1.0，4.0)分比1.0(1.0，2.0)分］，差异均有统计学意义（均P<0.05）。抗栓治疗组口服质子泵抑制剂比例明显高于对照组［27.0%（55/204）比6.1%（3/49）］，差异有统计学意义（P<0.001）。结论 抗栓治疗患者较未接受抗栓治疗的患者胃和小肠黏膜损伤明显增加。出血患者中小肠出血占比明显增加。磁控胶囊内镜可用于抗栓治疗患者胃和小肠黏膜损伤及病变的观察。

• Objective To investigate the clinical application value of magnetically controlled capsule endoscopy in patients with antithrombotic therapy. Methods The clinical data of 1 215 patients who underwent magnetically controlled capsule endoscopy at the Department of Gastroenterology, Beijing Anzhen Hospital, Capital Medical University from January 2019 to December 2023 were retrospectively analyzed. The patients were divided into antithrombotic therapy group (413 cases) and control group (802 cases, without antithrombotic drugs) according to whether they took antithrombotic drugs or not. The general data and endoscopic findings were compared between the two groups and between the patients with gastrointestinal bleeding. Results The proportion of gastrointestinal bleeding in the antithrombotic therapy group was significantly higher than that in the control group ［49.4%(204/413) vs 6.1%(49/802)］, and the proportions of overt bleeding and occult bleeding were also higher than those in the control group (all P<0.001). The proportions of gastric ulcer, small intestinal ulcer, jejunoileum ulcer, modified Lanza score of gastric mucosal injury and grading score of small intestinal mucosal injury in antithrombotic therapy group were significantly higher than those in control group (all P<0.05). The proportion of small intestinal bleeding, Lanza score of gastric mucosal injury and small intestinal mucosal injury grading score in antithrombotic therapy group were significantly higher than those in control group ［52.0%(106/204) vs 18.4%(9/49), 2.0(1.0, 4.0) vs 1.0(1.0, 2.0), 2.0(1.0, 4.0) vs 1.0(1.0, 2.0)］(all P<0.05). The proportion of oral proton pump inhibitors in the antithrombotic therapy group was significantly higher than that in the control group ［27.0%(55/204) vs 6.1%(3/49)］(P<0.001). Conclusion Gastric and small intestinal mucosal injuries were significantly increased in patients with antithrombotic therapy compared with those without antithrombotic therapy. The proportion of small intestinal bleeding in bleeding patients increased significantly. Magnetically controlled capsule endoscopy can be used to observe gastric and small intestinal mucosal injury and lesions in patients with antithrombotic therapy.