炎症性肠病患者肺部异常的临床特征研究  

Clinical features of pulmonary abnormalities associated with inflammatory bowel disease

作　　者：吴东[1] 杨红[1] 李玥[1] 李景南[1] 钱家鸣[1] 

机构地区：[1]中国医学科学院北京协和医学院北京协和医院消化科,北京100730

出　　处：《胃肠病学和肝病学杂志》2016年第10期1132-1135,共4页Chinese Journal of Gastroenterology and Hepatology

基　　金：卫生行业科研专项基金(No.201002020)

摘　　要：目的 总结炎症性肠病（IBD）患者肺部异常的病因、临床表现和转归。方法 回顾性分析2009年12月-2015年12月北京协和医院收治的IBD合并肺部异常患者11例,并随机抽取另外33例无肺部受累的IBD病例,进行对照研究。结果 11例患者中男8例（72.7%）,年龄24~72岁,平均（48.0±19.7）岁。病因包括IBD相关性肺疾病5例（肉芽肿性肺炎1例、淋巴细胞间质性肺炎1例、哮喘1例、肺栓塞2例）和机会性感染6例（肺结核2例、铜绿假单胞菌肺炎1例、曲霉菌肺炎1例、卡式肺孢子菌肺炎1例、巨细胞病毒肺炎1例）。研究组的住院时间（46.7±21.4）d,手术率为54.5%（6例）,与对照组比较,差异有统计学意义（P〈0.05）。结论 肺部受累可加重IBD病情,增加医疗花费,是预后不良的危险因素。在诊断IBD相关性肺疾病之前应先排除感染。Objective To evaluate the etiology, clinical features and outcome of pulmonary diseases associated with inflammatory bowel disease （IBD）. Methods Eleven IBD patients complicated with lung abnormalities and 33 controls in our institute from Dec. 2009 to Dec. 2015 were analyzed. Results The study group had 8 male （72.7%） and an average age of （48.0 ±19.7） years old （24 -72 years old）. IBD-related lung diseases included one case of granuloma- tous pneumonia, one case of lymphocytic interstitial pneumonia, one case of asthma and two cases of pulmonary embo- lus. Six patients had opportunistic pulmonary infections including two cases of tuberculosis, one cases of pseudomonas aeruginosa, one case of aspergillus, one case of pneumocystis jiroveci and one case of cytomegalovirus. Length of hospital stay （46.7 ±21.4） days and surgical operation rate （54.5%） in the study group were significantly higher than those in the control group （P 〈 0.05）. Conclusion Pulmonary involvement is associated with higher disease severity, more expense and worse prognosis in IBD. Opportunistic infections should be excluded before making a diagnosis of IBD-relat- ed lung disease.

关 键 词：炎症性肠病 溃疡性结肠炎 克罗恩病 炎症性肠病相关性肺疾病 机会性感染 肺栓塞 

分 类 号：R574.62[医药卫生—消化系统]