溃疡性结肠炎临床严重度分型与内镜、病理分级的关系  

Correlation among clinical severity, grading of endoscopy and histology in patients with ulcerative colitis

作　　者：黄红丽[1] 聂玉强[1] 李瑜元[1] 

机构地区：[1]广州市第一人民医院消化内科,510180

出　　处：《现代消化及介入诊疗》2008年第2期79-81,共3页Modern Interventional Diagnosis and Treatment in Gastroenterology

摘　　要：目的研究溃疡性结肠炎(UC)的临床严重度分型与病变范围及内镜、病理分级的关系。方法收集本院1998年1月至2007年10月住院确诊的UC患者,采用分级的方法描述UC的临床严重程度及内镜、病理组织学特点。运用Spearman等级相关系数进行相关分析。结果轻度UC(112例)病变范围多见于直肠及左侧结肠,中度UC(56例)以左侧结肠炎及广泛性结肠炎为主,重度UC(18例)以广泛性结肠炎为主(χ2=26.079,P<0.01);患者临床严重度分级与病理组织学分级(r=0.520,P=0.000)、内镜分级(r=0.169,P=0.012)均呈正相关性;在临床完全缓解的88例中,肠镜及组织学分级为0级分别仅有21、24例,临床完全缓解和结肠镜分级为0级的21例中,10例组织学仍有I级的改变。结论UC患者病变范围、内镜分级及活检黏膜的病理组织学分级能反映UC的活动性和严重性,在疗效评价中,组织学分级优于肠镜分级,肠镜分级优于临床分级。Objective To investigate the correlation among the clinical severity, grading of endoscopy and mucosal histology in patients with ulcerative colitis （UC）. Methods The data from 186 patients with UC were retrospectively collected to calculate the Spearman correlation coefficients among the clinical severity, the pathology and endoscopy grading. Results The severity of symptoms was related to the extent of colonic involvement（x^2 = 26.079, P 〈 0.01 ）, mild UC（112 cases） mostly involved rectum and left-sided colon, while moderate（56 cases） mostly involved left-sided colon and pancolon, severe UC（56 cases） mainly involved pancolon. There were significant positive correlations between clinical severity and histological grading（r = 0.520, P = 0.000）, and clinical severity with endoscopic grading （r = 0.169, P = 0.012 ）. In 88 patients with clinical remission after treatment for 6 weeks, there were 21 and 24 cases with 0 grade in endoscopies and histology respectively, and 10 cases in the former group fall in histological grade I. Conclusion The severity of UC is positively related to the extent of colonic involvement and grading in endoscopy and mucosal histological changes. For the evaluation of therapy, the sequence of priority is histological grading, endoscopic grading, and then clinical grading.

关 键 词：溃疡性结肠炎 临床 内镜 病理 

分 类 号：R259.746.2[医药卫生—中西医结合] R596[医药卫生—中医内科学]