發(fā)布時(shí)間：2018-12-23 10:07

【摘要】：目的分析白塞病合并的腸道病變類(lèi)型,為進(jìn)一步診治白塞病合并腸道病變提供參考依據(jù)。方法收集401例完成纖維結(jié)腸鏡檢查的白塞病患者的基本資料、腸鏡、病理及血液學(xué)檢查情況,對(duì)腸道病變進(jìn)行統(tǒng)計(jì)描述,并分析不同腸道病變的部位及血液學(xué)指標(biāo)的差異。結(jié)果401例白塞病患者中有腸道改變者88例(21.95%)。腸潰瘍(包括活動(dòng)期及愈合期)52例(12.97%),以回盲部多見(jiàn),其中62.86%(占白塞病患者5.49%,22/401)未訴胃腸道相關(guān)癥狀。潰瘍活動(dòng)期炎癥指標(biāo)較愈合期高,其中C反應(yīng)蛋白(C reactive protein,CRP)差異具有統(tǒng)計(jì)學(xué)意義(P=0.028)。腺瘤(包括管狀腺瘤、鋸齒狀腺瘤、絨毛狀腺瘤)33例(8.23%),以直、乙狀結(jié)腸,尤其是直乙交界處最為常見(jiàn);腺瘤主要發(fā)生于年齡較大者,與白塞病無(wú)腸道病變或合并潰瘍者差異有統(tǒng)計(jì)學(xué)意義(P=0.022,0.000),天冬氨酸氨基轉(zhuǎn)移酶(aspartate aminotransferase,AST)、γ-谷氨酰基轉(zhuǎn)移酶(gamma-glutansferase,GGT)及尿酸(uric acid,UA)升高,臨床實(shí)驗(yàn)室檢查差異與年齡增高相關(guān)。另見(jiàn)2例大腸黑變病及1例盲腸憩室。結(jié)論白塞病合并腸潰瘍或腺瘤占相當(dāng)一部分比例,且白塞腸病或白塞病合并腺瘤患者常未訴相關(guān)癥狀,故行常規(guī)腸鏡檢查對(duì)白塞病的診治是必要的。
[Abstract]:Objective to analyze the types of intestinal lesions associated with Behcet's disease and to provide reference for the diagnosis and treatment of Behcet's disease with intestinal lesions. Methods A total of 401 patients with Behcet's disease underwent fiberoptic colonoscopy were collected, including the data of colonoscopy, pathology and hematology, and the statistical description of intestinal lesions were carried out, and the differences of the location and hematological indexes of different intestinal lesions were analyzed. Results of 401 patients with Behcet's disease, 88 (21.95%) had intestinal changes. 52 cases (12.97%) had intestinal ulcers (including active and healing stages), most of which were ileocecal, 62.86% (5.4922 / 401) of them did not complain of gastrointestinal symptoms. The inflammatory index in active stage of ulcer was higher than that in healing stage, and the difference of C-reactive protein (C reactive protein,CRP) was statistically significant (P0. 028). 33 cases (8.23%) were adenomas (including tubular adenomas, serrated adenomas and villous adenomas). The most common cases were straight, sigmoid colon, especially at the junction of straight B; Adenoma mainly occurred in the older group, and there was significant difference between the patients without intestinal lesions or with ulcers (P0.0220.000), aspartate aminotransferase (aspartate aminotransferase,AST) and 緯 -glutamyltransferase (gamma-glutansferase,). GGT and uric acid (uric acid,UA) were increased, and the difference of clinical laboratory examination was related to the increase of age. Two cases of large bowel melanosis and one case of cecal diverticulum were also seen. Conclusion Behcet's disease complicated with intestinal ulcer or adenoma accounts for a considerable proportion, and patients with Behcet's bowel disease or Behcet's disease with adenoma often do not complain of related symptoms, so routine enteroscopy is necessary for the diagnosis and treatment of Behcet's disease.
【作者單位】： 復(fù)旦大學(xué)附屬華東醫(yī)院免疫風(fēng)濕科;復(fù)旦大學(xué)附屬華東醫(yī)院消化科;
【基金】：上海衛(wèi)生系統(tǒng)第二批重要疾病聯(lián)合攻關(guān)重點(diǎn)項(xiàng)目(2014ZYJB0010)~~
【分類(lèi)號(hào)】：R57;R597.9

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