诊断性抗结核治疗在鉴别肠道克罗恩病与肠结核中的意义

发布时间：2018-02-22 18:45

本文关键词： 诊断性抗结核治疗克罗恩病肠结核　出处：《四川大学学报(医学版)》2015年02期 　论文类型：期刊论文

【摘要】：目的评价诊断性抗结核治疗在鉴别肠道克罗恩病(CD)与肠结核(ITB)中的作用。方法回顾性分析本院近4年来(2009年1月至2013年10月)因肠道病变诊断不明,接受2~3个月诊断性抗结核治疗,最后确诊为CD或ITB患者的临床及内镜检查资料;以最终的综合诊断为标准,对诊断性抗结核治疗在鉴别CD和ITB中的准确性、敏感性和特异性进行评估。结果研究共纳入64例患者,其中肠结核33例,克罗恩病31例。在最终确诊为肠结核的患者中,31例患者经诊断性抗结核治疗后,其临床及内镜表现明显改善,红细胞沉降率(ESR)和C反应蛋白(CRP)明显下降(P0.05),血红蛋白(HGB)明显上升(P0.05)。相反,在最终确诊为克罗恩病的患者中,只有3例患者临床症状及内镜表现有一定改善。克罗恩病患者的克罗恩病疾病活动指数(CDAI)评分在诊断性抗结核治疗的前后差异并无统计学意义。诊断性抗结核治疗在鉴别CD和ITB中的准确性、敏感性和特异性分别为92.19%、93.94%、90.32%。结论诊断性抗结核治疗有助于CD和ITB的鉴别诊断,在临床上具有一定的可行性。
[Abstract]:Objective to evaluate the role of diagnostic antituberculous therapy in differentiating intestinal Crohn's disease (CD) from intestinal tuberculosis (ITB). Methods the diagnosis of intestinal diseases in our hospital was analyzed retrospectively in the past 4 years (from January 2009 to October 2013). The clinical and endoscopic data of patients with CD or ITB were treated with 2 ~ 3 months of diagnostic antituberculous therapy, and the accuracy of diagnostic antituberculous therapy in differentiating CD from ITB was evaluated according to the criteria of final comprehensive diagnosis. Results A total of 64 patients were included in the study, including 33 patients with intestinal tuberculosis and 31 patients with Crohn's disease. The clinical and endoscopic manifestations were significantly improved, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were significantly decreased (P 0.05), and hemoglobin HGBwas significantly increased (P 0.05). On the contrary, in the patients with Crohn's disease, the erythrocyte sedimentation rate (RSR) and C-reactive protein (CRP) were significantly decreased. There was no significant difference in the activity index of Crohn's disease (CDAII) score before and after diagnosis of antituberculous therapy in 3 patients with Crohn's disease. The accuracy of therapy in differentiating CD from ITB, The sensitivity and specificity were 92.199.94 and 90.32.ConclusionDiagnostic antituberculous therapy is helpful to the differential diagnosis of CD and ITB, and has certain clinical feasibility.
【作者单位】：四川大学华西医院消化内科;
【分类号】：R574.62;R524

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