超声内镜测量肠壁厚度对判断克罗恩病活动性的价值

发布时间：2018-06-04 00:02

本文选题：克罗恩病 + 黏膜下层　；参考：《广西医科大学》2017年硕士论文

【摘要】：目的初步探讨超声内镜(EUS)测量黏膜下层厚度对判断克罗恩病(CD)活动性的临床价值。方法对10例临床确诊为活动期CD的患者及10例同期健康对照者进行结肠镜及EUS检查,观察镜下改变、记录克罗恩病简易镜下评分(SES-CD)及测量病变最重部位的黏膜下层厚度,随访并测量其缓解期相同病变部位黏膜下层厚度,对比CD患者治疗前后黏膜下层厚度改变,分析黏膜下层厚度与CD活动的相关性,并计算出黏膜下层厚度诊断CD活动性的最佳阈值。结果10例CD患者活动期黏膜下层厚度为(6.48±1.95)mm,缓解期为(2.47±1.08)mm(P0.01);相关性分析显示黏膜下层厚度与克罗恩病活动指数(CDAI)值呈正相关(r=0.708,P0.01),与SES-CD评分呈正相关(r=0.807,P0.01)。对10例EUS下黏膜下层厚度进行受试者工作特征曲线分析,曲线下面积为0.985(P0.01)。当黏膜下层厚度取3.85mm作为阈值时,敏感度为100%,特异度为90%,Youden指数为0.90。结论EUS测量黏膜下层厚度有助于评估CD的活动性,从而有助于指导临床治疗。
[Abstract]:Objective to evaluate the clinical value of submucosal thickness measurement by EUS in judging the activity of Crohn's disease (Crohn's disease). Methods the colonoscopy and EUS examination were performed in 10 patients with active CD and 10 healthy controls. The changes under microscope were observed. The score of SES-CDand the thickness of submucous membrane at the most serious site of Crohn's disease were recorded. The submucosal thickness of the same lesion was measured at the same stage of remission. The changes of submucosal thickness were compared before and after treatment in CD patients, and the correlation between submucosal thickness and CD activity was analyzed. The optimal threshold value of submucosal thickness for CD activity was calculated. Results the submucosal thickness of 10 patients with CD was 6.48 卤1.95 mm in active stage and 2.47 卤1.08 mm in remission stage (P 0.01). The correlation analysis showed that the thickness of submucosal submucosa was positively correlated with the activity index of Crohn's disease (CDAII), and positively correlated with the SES-CD score. The submucosal thickness of 10 patients with EUS was analyzed by the operating characteristic curve. The area under the curve was 0.985 (P 0.01). When 3.85mm was taken as the threshold, the sensitivity was 100 and the specificity was 90. The Youden index was 0. 90. Conclusion the measurement of submucosal thickness by EUS is helpful to evaluate the activity of CD and to guide clinical treatment.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R574.62

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