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白塞病合并肠道病变临床回顾性分析

发表者:陈永 人已读

陈永1,刘文静2,邹峻1,罗丹1,蔡剑飞1,管剑龙1△

复旦大学附属华东医院,1免疫风湿科,2消化科上海 200040

【摘要】目的分析白塞病合并的肠道病变类型,为进一步诊治白塞病合并肠道病变提供参考依据。方法收集我院完成纤维结肠镜检查的401例白塞病患者的基本资料、肠镜、病理及血液学检查情况,对肠道病变进行统计描述,并分析不同肠道病变的部位、血液学指标的差异。结果 401例白塞病患者中有肠道改变者88例(21.95%)。肠溃疡(包括活动期及愈合期)52例(12.97%),以回盲部多见,其中62.86%(占白塞病患者22/401(5.49%))未诉胃肠道相关症状。溃疡活动期炎症指标较愈合期高,其中CRP具有统计学差异(P=0.028)。腺瘤(包括管状腺瘤、锯齿状腺瘤、绒毛状腺瘤)33例(8.23%),以直、乙状结肠,尤其是直乙交界处最为常见;腺瘤主要发生于年纪较大者,与白塞病无肠道病变、或合并溃疡者者有统计学差异(P=0.022,0.000),AST、GGT、UA升高,呈与年龄增高相关的临床实验室检查差异。另见2例大肠黑变病及1例盲肠憩室患者。结论白塞病合并肠溃疡或腺瘤占相当一部分比例,且白塞肠病白塞病合并腺瘤患者常未诉相关症状,故行常规肠镜检查对白塞病的诊治是必要的。复旦大学附属华东医院免疫风湿科陈永

【关键词】白塞病;肠溃疡;腺瘤;结肠镜;病理

基金资助:上海卫生系统第二批重要疾病联合攻关重点项目(2014ZYJB0010)

Intestinal pathological changes in Behcet’s disease: a clinical retrospective study

CHEN Yong1, LIU Wenjing2, ZOU Jun1, LUO Dan1, CAI Jianfei1, GUAN Jianglong1△

1. Rheumatologic Department; 2. Gastrointestinal Department;

Huadong Hospital, Fudan University Shanghai 200040,China

【Abstract】Objective To analyze the characteristics of Behcet’s disease (BD) with intestinal lesions to provides further reference for the diagnosis and treatment. Methods 401 cases of BD patients’ data were collected including basic data, colonoscopy report, pathology diagnosis and hematologic examination. Statistical description of intestinal lesions was applied and analyzed the differences between the locations, blood examinations of intestinal lesions. Results Within this 401 BD patients, 88 (21.95%) with intestinal lesions. Intestinal ulcerations, including both active and inactive phase appeared in 52 cases (12.97%), mostly founded in ileocecum, in which 62.86% (takes part 22/401 (5.49%) of all BD patients) without the abdominal discomfort. Compared with inactive phase, the active phase intestinal BD patients have higher inflammation indexes with CRP increased of statistical significance (P=0.028). 33 cases (8.23%) with adenomas, including tubular adenoma, serrated adenoma and villous adenoma were founded. Mostly occurred in rectum, sigmoid colon, especially the sigmoidcolonrectum junction. Adenomas were seen in elder patients with statistical significance compared to BD without intestinal lesion or with intestinal ulceration patients (P=0.022,0.000), and exhibited elder changes of lab tests, such as increased in AST, GGT and UA. 2 cases of melanosis coli and 1 case of caecal diverticulum were also founded. Conclusion This study found that BD patients with intestinal ulcer or adenoma takes a fairly high ratio, and most intestinal BD and BD with adenoma patients did not complaint related symptoms, so colonoscopy as a screening method for diagnosis and treatment of BD is necessary.

【Key words】Behcet’s disease; intestinal ulceration; adenoma; colonoscopy; pathology

This work was supported by the Shanghai Health System Key Joint Research Project on Important Diseases of the Second Batch (2014ZYJB0010)

△Corresponding author: E-mail:guanjianlong@medmail.com.cn

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发表于:2017-08-14 16:08

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