CAJ | 학술논문

目的探讨内镜超声检查(EUS)和白光内镜、放大内镜在判断溃疡性结肠炎(UC)严重程度中的一致性和互补性.方法确诊的125例UC患者经白光内镜和EUS检查,其中51例行放大内镜检查.根据白光内镜黏膜形态、放大内镜腺开口进行分级,比较各分级下内镜超声测得的肠壁总厚度.结果白光内镜下判断UC炎症程度:重度16例、中度46例、轻度44例、缓解期19例,EUS测得肠壁总厚度分别为(5.903±1.551 )mm、(4.673±1.235 )mm、( 3.756±1.322) mm、(3.464±0.970) mm,除轻度与缓解期比较差异无统计学意义外,其他组别两两比较,差异均有统计学意义(P＜0.05).放大内镜下根据UC炎症程度分为,绒毛状结构(9例)、典型珊瑚礁状结构(9例)、重度珊瑚礁状结构(8例)、规则腺开口(13例)、上皮微小缺损(6例)、小黄色斑(6例),肠壁总厚度分别为(5.701 ±0.941) mm、(5.518±0.581) mm、(5.181±0.751)mm、(3.763±0.659) mm、( 3.587±0.461) mm和(2.505±0.330 )mm,除上皮微小缺损与规则腺开口、典型与重度珊瑚礁状结构和绒毛状结构之间比较,差异无统计学意义外,其他组别两两比较,差异均有统计学意义(P＜0.05).超声内镜评估黏膜深度,小黄色斑(6/6)、规则腺开口(10/13)多位于黏膜层,而重度珊瑚礁状结构(8/8)病变均浸润至固有肌层.结论 EUS对判断UC炎症程度及浸润深度和白光内镜、放大内镜具有一定的一致性,可达到辅助或替代放大内镜判断效果.
목적 탐토내경초성검사(EUS)화백광내경、방대내경재판단궤양성결장염(UC)엄중정도중적일치성화호보성.방법 학진적125례UC환자경백광내경화EUS검사,기중51례행방대내경검사.근거백광내경점막형태、방대내경선개구진행분급,비교각분급하내경초성측득적장벽총후도.결과 백광내경하판단UC염증정도:중도16례、중도46례、경도44례、완해기19례,EUS측득장벽총후도분별위(5.903±1.551 )mm、(4.673±1.235 )mm、( 3.756±1.322) mm、(3.464±0.970) mm,제경도여완해기비교차이무통계학의의외,기타조별량량비교,차이균유통계학의의(P＜0.05).방대내경하근거UC염증정도분위,융모상결구(9례)、전형산호초상결구(9례)、중도산호초상결구(8례)、규칙선개구(13례)、상피미소결손(6례)、소황색반(6례),장벽총후도분별위(5.701 ±0.941) mm、(5.518±0.581) mm、(5.181±0.751)mm、(3.763±0.659) mm、( 3.587±0.461) mm화(2.505±0.330 )mm,제상피미소결손여규칙선개구、전형여중도산호초상결구화융모상결구지간비교,차이무통계학의의외,기타조별량량비교,차이균유통계학의의(P＜0.05).초성내경평고점막심도,소황색반(6/6)、규칙선개구(10/13)다위우점막층,이중도산호초상결구(8/8)병변균침윤지고유기층.결론 EUS대판단UC염증정도급침윤심도화백광내경、방대내경구유일정적일치성,가체도보조혹체대방대내경판단효과.
Objective To study the consistency and complementarity of endoscopic ultrasonography (EUS),white light endoscopy (WLE) and magnifying endoscopy (ME) in diagnosis of ulcerative colitis (UC).Methods We collected 125 cases of UC patients diagnosed by WLE and EUS (including 51 cases of WLE + ME + EUS).According to UC mucosal morphology under WLE and crypt openings under ME,we divided all the cases into several groups and analyzed intestinal wall thickness (TWT) under EUS in each group.Results According to the results of UC inflammation degree under WLE,all patients were divided into four groups: 16 severe cases,46 moderate cases,44 mild,and 19 remission stage.TWT results were (5.903 ± 1.551 ) mm,(4.673 ± 1.235 ) mm,(3.756 ± 1.322 )mm and ( 3.464 ± 0.970) mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ),except for that between mild and remission groups.According to the results of UC inflammation degree under ME,all patients were divided into six groups: 9 cases of villous-like structure,9 cases of typical coral reef-like structure,8 severe coral reef-like structure,13 regular crypt opening,6 epithelial minimal defect and 6 small yellow spot (SYS).TWT results were (5.701 ±0.941 )mm,(5.518 ±0.581 )mm,(5.181 ±0.751 )mm,(3.763 ±0.659) mm,(3.587 ±0.461 )mm and (2.505 ± 0.330 )mm,respectively.Differences were significant between any two groups ( P ＜ 0.05 ) except for those between epithelial minimal defect and regular crypt opening,typical coral reeflike structure,villous-like and severe coral reef-like structure.EUS results showed SYS (6/6) and regular crypt opening ( 10/13 ) were mostly located in mucosa,while lesions of severe coral reef-like structure (8/8) invaded the muscularis propria.Conclusion EUS shows high consistency with WLE and ME in diagnosis of UC inflammation degree and invasive depth.It could assist and even substitute ME for evaluation.