白塞病合并肠道病变的临床回顾性分析

发布时间：2018-12-23 10:07

【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401例完成纤维结肠镜检查的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及血液学指标的差异。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5.49%,22/401)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C反应蛋白(C reactive protein,CRP)差异具有统计学意义(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;腺瘤主要发生于年龄较大者,与白塞病无肠道病变或合并溃疡者差异有统计学意义(P=0.022,0.000),天冬氨酸氨基转移酶(aspartate aminotransferase,AST)、γ-谷氨酰基转移酶(gamma-glutansferase,GGT)及尿酸(uric acid,UA)升高,临床实验室检查差异与年龄增高相关。另见2例大肠黑变病及1例盲肠憩室。结论白塞病合并肠溃疡或腺瘤占相当一部分比例,且白塞肠病或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。
[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 纬 -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.
【作者单位】：复旦大学附属华东医院免疫风湿科;复旦大学附属华东医院消化科;
【基金】：上海卫生系统第二批重要疾病联合攻关重点项目(2014ZYJB0010)~~
【分类号】：R57;R597.9

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