中华消化杂志
中華消化雜誌
중화소화잡지
Chinese Journal of Digestion
2010年
1期
11-14
,共4页
李学锋%邹益友%周明欢%伍仁毅%吴小平%卢放根
李學鋒%鄒益友%週明歡%伍仁毅%吳小平%盧放根
리학봉%추익우%주명환%오인의%오소평%로방근
克罗恩病%肠结核%内镜%诊断%鉴别
剋囉恩病%腸結覈%內鏡%診斷%鑒彆
극라은병%장결핵%내경%진단%감별
Crohns disease%Intestinal tuberculosis%Clinic%Endoscopy%Diagnosis%differential
目的 探讨克罗恩病(CD)与肠结核(ITB)的临床及内镜特点,为两者的临别诊断提供依据.方法 回顾性分析2003年6月-2009年2月168例CD患者和156例ITB患者的临床及内镜资料.结果 CD以男性为主(男;女为108:60),肠道手术率较ITB高[(33.3%比10.9%,P<0.01)];CD的腹泻、便血、肛周疾病、肠梗阻的发生率分别为66.1%、32.1%、16.1%和28.0%.明显高于ITB组(分别为47.0%、7.7%、3.4%和9.4%,P值<0.05或<0.01);而ITB的发热、盗汗多于CD组(P值均<0.05),且伴肺结核、腹水发生率明显高于CD组(P值均<0.01);ITB的球蛋白升高、红细胞沉降率增快、结核菌素纯蛋白衍化物试验阳性率、结核抗体阳性率均高于CD组;CD患者内镜下纵行溃疡、网格状溃疡、卵石征、肠腔狭窄均多于ITB组(P值<0.01或<0.05),而ITB的环行溃疡、同盲瓣受累多见(P值<0.01或<0.05),且受累的回盲瓣常变形和开口固定.结论 CD与ITB各有其临床特点,临床特点结合内镜下卵石征、纵行溃疡、网格状溃疡、环行溃疡出现的概率、回盲瓣受累情况及形态变化是鉴别两者的重要特征.
目的 探討剋囉恩病(CD)與腸結覈(ITB)的臨床及內鏡特點,為兩者的臨彆診斷提供依據.方法 迴顧性分析2003年6月-2009年2月168例CD患者和156例ITB患者的臨床及內鏡資料.結果 CD以男性為主(男;女為108:60),腸道手術率較ITB高[(33.3%比10.9%,P<0.01)];CD的腹瀉、便血、肛週疾病、腸梗阻的髮生率分彆為66.1%、32.1%、16.1%和28.0%.明顯高于ITB組(分彆為47.0%、7.7%、3.4%和9.4%,P值<0.05或<0.01);而ITB的髮熱、盜汗多于CD組(P值均<0.05),且伴肺結覈、腹水髮生率明顯高于CD組(P值均<0.01);ITB的毬蛋白升高、紅細胞沉降率增快、結覈菌素純蛋白衍化物試驗暘性率、結覈抗體暘性率均高于CD組;CD患者內鏡下縱行潰瘍、網格狀潰瘍、卵石徵、腸腔狹窄均多于ITB組(P值<0.01或<0.05),而ITB的環行潰瘍、同盲瓣受纍多見(P值<0.01或<0.05),且受纍的迴盲瓣常變形和開口固定.結論 CD與ITB各有其臨床特點,臨床特點結閤內鏡下卵石徵、縱行潰瘍、網格狀潰瘍、環行潰瘍齣現的概率、迴盲瓣受纍情況及形態變化是鑒彆兩者的重要特徵.
목적 탐토극라은병(CD)여장결핵(ITB)적림상급내경특점,위량자적림별진단제공의거.방법 회고성분석2003년6월-2009년2월168례CD환자화156례ITB환자적림상급내경자료.결과 CD이남성위주(남;녀위108:60),장도수술솔교ITB고[(33.3%비10.9%,P<0.01)];CD적복사、편혈、항주질병、장경조적발생솔분별위66.1%、32.1%、16.1%화28.0%.명현고우ITB조(분별위47.0%、7.7%、3.4%화9.4%,P치<0.05혹<0.01);이ITB적발열、도한다우CD조(P치균<0.05),차반폐결핵、복수발생솔명현고우CD조(P치균<0.01);ITB적구단백승고、홍세포침강솔증쾌、결핵균소순단백연화물시험양성솔、결핵항체양성솔균고우CD조;CD환자내경하종행궤양、망격상궤양、란석정、장강협착균다우ITB조(P치<0.01혹<0.05),이ITB적배행궤양、동맹판수루다견(P치<0.01혹<0.05),차수루적회맹판상변형화개구고정.결론 CD여ITB각유기림상특점,림상특점결합내경하란석정、종행궤양、망격상궤양、배행궤양출현적개솔、회맹판수루정황급형태변화시감별량자적중요특정.
Objective To compare the clinical features and endoscopic findings of Crohn's disease(CD) and intestinal tuberculosis(ITB) in order to differentiate CD from ITB. Methods The clinical and endoscopic data from 168 patients with CD and 156 patients with ITB between June 2003 and February 2009 were retrospectively analyzed. Results The salient features of CD were male patients in predominance (male : female was 108 :60) and high incidence of colectomy (CD 33.3% vs ITB 10.9%, P<0.01). Diarrhea (66.1%), hematochezia (32.1%), perianal disease (16.1%), intestinal obstruction (28.0%) were more frequent in CD patients than in ITB patients (47.0%, 7.7%, 3.4%, 9.4% respectively, all P values<0.05). The salient features of ITB were night sweating, pulmonary tuberculosis, ascites, hyperglobulin, increased erythrocyte sedimentation rate and the positive serum antibody to mycobacterium. The endoscopic examination showed that the fissure-shape ulcer, grid-shape ulcer, cobblestone sign and intestinal stricture were more frequent in CD patients than in ITB patients (all P values <0.05). Whereas the circular ulcer and involved ileocecal valve with fixed bouche shape were more common in ITB patients (P<0.05). Conclusions The clinical characteristics are different in CD and ITB patients. The endoscopic findings including fissure-shape ulcer, grid-shape ulcer, circular ulcer, cobblestone sign and the status of involved ileocecal valve are important in the differentiation of ITB from CD.
