双气囊内镜在小肠克罗恩病疗效随访中的应用价值初探  

Double-balloon endoscopy in follow-up of Crohn disease in small intestine

作　　者：徐妹琪[1] 钟捷[1] 程时丹[1] 王立夫[1] 张曙[1] 张晨莉[1] 陈明[1] 

机构地区：[1]上海市瑞金医院消化科,200025

出　　处：《中华消化内镜杂志》2009年第9期467-470,共4页Chinese Journal of Digestive Endoscopy

摘　　要：目的探讨双气囊内镜（DBE）在小肠克罗恩病（CD）疗效随访中的应用和价值。方法对41例曾行DBE检查并临床确诊为小肠CD的患者进行正规药物治疗并随访，评估临床症状、血清学指标、治疗时间与DBE下黏膜修复情况之间的关系。结果治疗1个月后92．7％的患者症状缓解，2个月后97．6％C-反应蛋白恢复正常。行DBE复查黏膜无明显改善或略有改善、改善、明显改善者，平均复查时间为治疗后（7．1±4．3）、（16．5±7．1）、（25．0±12．7）个月，3组间复查时间差异有统计学意义（P〈0．01）。对于累及小肠-结肠的患者，同一个体的小肠、结肠黏膜修复程度差异无统计学意义（P=0．215）。结论小肠CD黏膜修复缓慢，明显迟于临床症状的缓解及C反应蛋白的恢复，合理的DBE复查时间为治疗后10～15个月，免疫抑制剂宜长期维持。对于同时累及小肠-结肠的患者，可行结肠镜复查。Objective To investigate the value of double-balloon endoscopy （DBE） in follow-up of Crohng disease （CD） in small intestine. Methods DBE was applied in follow-up of 41 patients who had already been diagnosed as having small intestine CD. The relationship between mucosal repairment and clinical symptoms, serologic markers, and duration of treatment was evaluated. Results Symptom remission was achieved in 92. 7% of patients after a month of treatment. Serum C reaction protein （CRP） level returned into normal limitation in 97.6% of patients after 2 months of treatment. The average time of DBE when mueosal lesions displayed no/ little improvement, improvement and marked improvement were 7. 1 ± 4. 3, 16. 5 ± 7. 1, 25.0 ± 12. 7 months after the treatment, respectively, which were significantly different （P 〈 0. 01 ）. For those patients in whom both small intestine and colon were involved, there was no difference between different locations in regarding of the improvement of mucosa （P = 0. 215 ）. Conclusion The mueosal recovery in small intestine CD is achieved more slowly than symptomatic relief and normalization of serum CRP. The ideal reexamination time of DBE is 10-15 months after the treatment with long-term immuno-depressant administration. For those in whom small intestine and colon are both involved, reexamination with colonoseopy is recommended.

关 键 词：克罗恩病 双气囊内镜 小肠 

分 类 号：R57[医药卫生—消化系统]