应用小探头超声预测溃疡性结肠炎缓解的价值  

Value of miniprobe sonography in predicting remission of ulcerative colitis

作　　者：夏璐[1] 刘慧黎[1] 戴欣[1] 徐凯[1] 诸琦[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院消化内科,上海200025

出　　处：《诊断学理论与实践》2008年第6期605-608,共4页Journal of Diagnostics Concepts & Practice

摘　　要：目的:通过小探头超声(MPS)检查,比较溃疡性结肠炎(UC)治疗前后肠壁层次的变化,并初步评估MPS在判断UC活动度及预测缓解中的价值。方法:选择经临床表现、内镜及组织学检查证实为UC的患者40例,确诊后即予口服巴柳氮钠8周(6.75g/d)。观察并记录治疗前后患者的临床表现、内镜学改变、MPS检查(Fujinon SP702,15MHz)和组织学检查结果。MPS观察指标为全肠壁厚度、各层次间分界、黏膜下层厚度、黏膜下层中扩张血管数和病灶周围肿大淋巴结数。结果:共36例患者完成观察。治疗后患者临床表现均较治疗前有显著改善,其中组织学证实达缓解者26例(72.2%),症状缓解者31例(86.1%)。MPS检查亦有明显好转,黏膜下层厚度在活动期较缓解期厚[(2.96±0.73)mm比(2.12±0.35)mm,P<0.01],并伴黏膜层-黏膜下层、黏膜下层-肌层分界不清,但缓解期全肠壁厚度与活动期间差异无统计学意义[(3.84±0.64)mm比(3.62±0.61)mm,P=0.15]。部分活动期患者可检出肿大淋巴结(20%),病情缓解后仍不消退;所有患者均未发现病理性扩张血管。结论:MPS有助于观察肠壁层次结构的变化,对判断UC患者的缓解及预后有一定实用价值。Objective Using miniprobe sonography （MPS） to compare layer changes of the bowel wall before and after treatment of ulcerative colitis（UC）, and evaluate preliminarily the value of MPS in assessing the activity and remission of UC. Methods Forty patients with UC confirmed by clinical manifestation, endoscopy and histology were enrolled. The patients were treated with balsalazide 6.75g/dx8 wks. Clinical manifestations, MPS and histological changes were observed before and after treatment. The observation parameters of MPS were total wall thickness, boundary of each layer, submucosal thickness, number of enlarged vessels in submueosa and number of enlarged lymph nodes surround the lesion. Results Thirty six of 40 patients completed the study. After treatment, the clinical manifestations were significantly improved. Histopathological remission was 72.2% and clinical effectiveness was 8611%. Marked improvement occurred in MPS. Submucosal thickness in UC active stage was significantly greater than that in remission stage [（2.96±0.73） mm vs （2.12±0.35） ram, P〈0.01], and was associated with blurred mucosal-submucosal and submucosal-muscularis propria boundary. No significant change of total wall ihiekness was seen in remission stage when compared to active stage [（3.84±0.64） mm vs （3.62±0.61）mm, P=-0.15]. Enlarged lymph nodes was observed in some cases （20%）, which were not regressed after remission. Pathologically enlarged blood vessels were not seen. Conclusions MPS is useful to evaluate the changes of bowel wall with UC, which has practical value in the assessment of remission and prognosis of UC.

关 键 词：小探头超声内镜 溃疡性结肠炎 诊断 

分 类 号：R445.1[医药卫生—影像医学与核医学]