小肠胶囊内镜下单纯小肠克罗恩病空回肠病变与回肠末端病变的关系  

The relationship between jejunal-ileum lesions and terminal ileum lesions of isolated small intestinal Crohn disease under small bowel capsule endoscopy

作　　者：张明[1] 邱琛[1] 朱振浩 陈昭[1] 向城 王新颖[1] 

机构地区：[1]南方医科大学南方医院消化内科,广州510515

出　　处：《中华消化内镜杂志》2017年第8期578-581,共4页Chinese Journal of Digestive Endoscopy

基　　金：广东省省级科技计划项目（2014A020212172）

摘　　要：目的探讨单纯小肠克罗恩病空回肠病变与回肠末端病变的关系，比较回肠末端正常与回肠末端异常的单纯小肠克罗恩病患者临床及内镜特征。方法回顾性分析南方医科大学南方医院2008年1月至2015年10月确诊且先后行结肠镜及小肠胶囊内镜检查的单纯小肠克罗恩病患者资料，根据患者内镜下表现分为回肠末端正常组及回肠末端病变组，并比较两组患者的临床及内镜特征。结果共62例单纯小肠克罗恩病患者纳入本研究，且均通过小肠胶囊内镜发现有空回肠病变。其中经结肠镜下发现回肠末端病变者40例（64．5％），回肠末端正常者22例（35．5％）。两者相比，回肠末端正常组较回肠末端病变组病程45年的比例高[68．2％（15／22）比12．5％（15／40），P=0．021]，两组患者性别及年龄分布、吸烟史、临床表现、上消化道累及、肛周病变、疾病行为、克罗恩病活动指数、炎症指标、营养状况等方面比较差异无统计学意义（P〉0．05）。结论结肠镜下回肠末端病变并不能预测空回肠是否有病变，小肠胶囊内镜有助于全小肠段病变的检出，对于病程短且回肠末端正常的克罗恩病患者更应重视空回肠病变的评估。Objective To study the relationship between jejunal-ileum lesions and terminal ileum lesions of patients with isolated small intestinal Crohn disease, and to compare the clinical and endoscopic features of patients having normal terminal ileum with those having abnormal terminal ileum in isolated small intestinal Crohn disease. Methods The data of patients diagnosed as having isolated small intestinal Crohn disease and successively receiving colonoscopy and small bowel capsule endoscopy in Nanfang Hospital of Southern Medical University from January 2008 to October 2015 were retrospectively analyzed. The patients were divided into normal terminal ileum group and abnormal terminal ileum group according to the result of colonoscopy. The clinical and endoscopic features of the two groups were compared. Results The data of 62 patients were collected, and jejunal-ileum lesions were found in all of the patients under small bowel capsule endoscopy. According to the result of colonoscopy, 40 patients （64. 5% ） were grouped to the abnormal terminal ileum group and 22 patients （35.5%） to the normal group. The patients in the normal terminal ileum group had a shorter disease duration than those of the abnormal group [68.2% （15/22） VS 12. 5% （ 15/40）, P =0. 021 ]. The sex and age distribution, smoking history, clinical feature, upper gastrointestinal involvement, perianal lesion, disease behavior, Crohn disease activity index, inflammation markers and nutriture between the two groups had no statistical difference （P〉0. 05）. Conclusion The terminal ileum lesions found by colonoscopy cannot predict small bowel lesions for Crohn disease. Small bowel capsule endoscopy is helpful for the detection of small intestinal lesions in Crohn disease. We should pay more attention to evaluating the small bowel lesions when the patients with Crohn disease have a short duration and normal terminal ileum.

关 键 词：克罗恩病 结肠镜检查 胶囊内窥镜 小肠 回肠末端 

分 类 号：R574.62[医药卫生—消化系统]