显微镜结肠炎临床特征及其相关危险因素分析

发布时间：2018-07-06 08:59

本文选题：显微镜结肠炎 + 淋巴细胞性结肠炎　；参考：《中国内镜杂志》2017年11期

【摘要】：目的分析慢性腹泻患者的临床、内镜及病理资料,探讨可能影响显微镜结肠炎(MC)的危险因素。方法前瞻性分析2016年6月-2017年4月该院门诊以水样腹泻为主诉患者的临床资料,常规结肠镜检查,多点取肠黏膜活检,行组织病理HE染色和Masson染色,对患者的病史及病理进行分析。结果 102例水样腹泻患者中诊断为MC 3例(3/102,2.94%),其中胶原性结肠炎(CC)3例,全部为女性,年龄24~36岁,淋巴细胞性结肠炎(LC)0例。结肠镜下肠黏膜基本正常或仅表现为轻度的充血水肿;病理组织学表现为上皮细胞损伤,上皮内淋巴细胞增多,固有层炎症细胞浸润,上皮下胶原带增厚。近期服用降糖药、质子泵抑制剂(PPIs)、面食等因素可能与MC发病关系密切。结论 MC是慢性水样腹泻的重要原因,临床症状及结肠镜表现均无特异性,慢性腹泻患者应尽早行结肠镜下多点活检明确诊断,其发病可能与使用某些药物(如降糖药、PPIs)和某些食物(面筋)有关。
[Abstract]:Objective to analyze the clinical, endoscopic and pathological data of patients with chronic diarrhea and to explore the risk factors of microscopical colitis (MC). Methods from June 2016 to April 2017, clinical data of patients with watery diarrhea were analyzed prospectively. Routine colonoscopy, multi-site biopsy of intestinal mucosa, HE staining and Masson staining were performed. The history and pathology of the patients were analyzed. Results among 102 cases of watery diarrhea, 3 cases were diagnosed as MC (3 / 1022 / 2.94%), including 3 cases of collagen colitis (CC), all of which were female, aged 24 ~ 36 years, and 0 cases of lymphocytic colitis (LC). Under colonoscopy, the intestinal mucosa showed normal or mild hyperemia and edema, and the histopathology showed that the epithelial cells were damaged, the intraepithelial lymphocytes were increased, inflammatory cells were infiltrated in the lamina propria, and the subepithelial collagen was thickened. Recent use of hypoglycemic drugs, proton pump inhibitors (PPIs), pasta and other factors may be closely related to the incidence of MC. Conclusion MC is an important cause of chronic watery diarrhea, and the clinical symptoms and colonoscopic manifestations are not specific. Patients with chronic diarrhea should be diagnosed by multipoint biopsy under colonoscopy as soon as possible. It may be associated with the use of certain drugs, such as hypoglycemic drugs (PPIs) and certain foods (gluten).
【作者单位】：杭州师范大学附属医院消化内科;
【分类号】：R574.62

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