中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2008年
8期
509-512
,共4页
克罗恩病%蒙特利尔分型%抗酿酒酵母抗体%预后
剋囉恩病%矇特利爾分型%抗釀酒酵母抗體%預後
극라은병%몽특리이분형%항양주효모항체%예후
Crohn's disease%Montreal classification%Anti-sarccharomyces cerevisiae antibody%Prognosis
目的 分析我国克罗恩病(CD)患者的蒙特利尔分型、治疗及预后特点,判断临床分型与抗酿酒酵母抗体(ASCA)、治疗方式和预后之间是否存在一定的关系.方法 按照蒙特利尔分型对102例CD患者进行临床分型,并记录ASCA、肠道外表现、治疗方式和随诊情况.比较各亚型之间的差异.结果 我国CD患者以A2亚型(52.9%)为主,回结肠受累(40.2%)和狭窄型病变(53.9%)多见,并发症的发生率与病程长短有关(P＜0.05),肠瘘与疾病部位有一定关系(P=0.074),B1亚型疾病进展率高于B2亚型(P=0.018),B3亚型手术率最高(P=0.002).ASCA阳性者占40.0%,ASCA阳性与病变部位、疾病行为、病情进展及治疗方式等无关(P＞0.05).结论 CD患者的疾病行为随病程延长发生进展,并发症发生率及手术率上升,发生穿透性病变是手术治疗的首要原因.蒙特利尔分型可有助于判断是否需要手术治疗以及疾病的预后.
目的 分析我國剋囉恩病(CD)患者的矇特利爾分型、治療及預後特點,判斷臨床分型與抗釀酒酵母抗體(ASCA)、治療方式和預後之間是否存在一定的關繫.方法 按照矇特利爾分型對102例CD患者進行臨床分型,併記錄ASCA、腸道外錶現、治療方式和隨診情況.比較各亞型之間的差異.結果 我國CD患者以A2亞型(52.9%)為主,迴結腸受纍(40.2%)和狹窄型病變(53.9%)多見,併髮癥的髮生率與病程長短有關(P＜0.05),腸瘺與疾病部位有一定關繫(P=0.074),B1亞型疾病進展率高于B2亞型(P=0.018),B3亞型手術率最高(P=0.002).ASCA暘性者佔40.0%,ASCA暘性與病變部位、疾病行為、病情進展及治療方式等無關(P＞0.05).結論 CD患者的疾病行為隨病程延長髮生進展,併髮癥髮生率及手術率上升,髮生穿透性病變是手術治療的首要原因.矇特利爾分型可有助于判斷是否需要手術治療以及疾病的預後.
목적 분석아국극라은병(CD)환자적몽특리이분형、치료급예후특점,판단림상분형여항양주효모항체(ASCA)、치료방식화예후지간시부존재일정적관계.방법 안조몽특리이분형대102례CD환자진행림상분형,병기록ASCA、장도외표현、치료방식화수진정황.비교각아형지간적차이.결과 아국CD환자이A2아형(52.9%)위주,회결장수루(40.2%)화협착형병변(53.9%)다견,병발증적발생솔여병정장단유관(P＜0.05),장루여질병부위유일정관계(P=0.074),B1아형질병진전솔고우B2아형(P=0.018),B3아형수술솔최고(P=0.002).ASCA양성자점40.0%,ASCA양성여병변부위、질병행위、병정진전급치료방식등무관(P＞0.05).결론 CD환자적질병행위수병정연장발생진전,병발증발생솔급수술솔상승,발생천투성병변시수술치료적수요원인.몽특리이분형가유조우판단시부수요수술치료이급질병적예후.
Objective To analysis the features of Montreal classification,serum markers,treatment and prognosis of Chinese patients with Crohn's disease(CD),and to estimate the relationships between clinical classification and anti-sarccharomyces cerevisiae antibody(ASCA),treatment and prognosis.Methods A retrospective study of 102 consecutive definite CD eases were performed and all subjects were classified into subtypes according to Montreal classification.The results of ASCA,extra-intestinal manifestation,treatment and disease behavior at follow-up were recorded and compared among different subtypes.Results The A2 subtype(52.9%)was dominated in Chinese CD patients.Ileocolon location(40.2%)and stricture lesion (53.9%)were common.The complication rate was dependent on disease course(P＜0.05),and intestinal fistula was associated with disease location(P=0.074).B1 subtype had higher progressive rate than B2 subtype(P=0.018).ASCA was not associated with disease loeation,disease behavior,treatment and disease progression(P＞0.05).Conclusions Crohn's disease mainly attack young people with male predominance.Early-onset CD patients have higher ASCA positive rate and disease progressive rate.The disease behavior progresses associated with disease course,and the rate of complication and the increase of surgery.The penetrating behavior is the main cause for surgery.Montreal classification is useful to predict the disease course,the need for surgery as well as the prognosis.
