共聚焦激光显微内镜对溃疡性结肠炎肠黏膜修复的病理改变评估  

Evaluation of confocal laser endomicroscopy on pathological changes of intestinal mucosa repairing for patients with ulcerative colitis

作　　者：沈海燕[1] 乐敏[2] 虞朝辉[2] 陈春晓 Shen Haiyan , Yue Min, Yu Chaohui, Chen Chunxiao.(Department of Gastroenterology, the Second Affiliated Hospital of Jiaxing College Medicine School, Jiaxing 314000, Chin)

机构地区：[1]嘉兴学院医学院附属第二医院消化内科,浙江省嘉兴市314000 [2]浙江大学医学院附属第一医院消化内科

出　　处：《中华消化内镜杂志》2018年第3期185-189,共5页Chinese Journal of Digestive Endoscopy

摘　　要：目的评价共聚焦激光显微内镜（CLE）在评判溃疡性结肠炎（UC）黏膜功能修复状态的优势作用。方法2014年7月至2016年12月间于浙江大学医学院附属第一医院确诊并治疗后复查的30例UC患者为研究组，选取同期行肠镜检查发现结肠息肉并拟行结肠息肉切除术的10例患者为对照组。两组患者均分别进行白光内镜及CLE检查，之后进行荧光素渗出情况分析。结果研究组中有10例患者白光内镜下全结肠段黏膜正常，另20例存在部分肠段黏膜异常，对照组全结肠段黏膜白光内镜下均显示正常。研究组白光内镜正常患者与对照组患者CLE下结肠荧光素钠渗出评分比较差异有统计学意义（P〈0.05）。研究组20例活动期UC患者中，白光内镜异常肠段与正常肠段CLE下荧光素钠渗出评分比较差异有统计学意义（P〈0.05）。Spearman相关性分析显示，研究组白光内镜下黏膜正常患者左半结肠黏膜CLE下荧光素钠渗出评分与活检组织病理组织学分级指数非等级相关（rs＝0.394，P〉0.05）。 结论通过CLE可发现UC患者黏膜愈合过程中首先为结构修复，白光内镜下黏膜愈合并不能代表功能修复。CLE评估黏膜屏障功能改变优于组织活检病理检查。ObjectiveTo evaluate the advantages of confocal laser endomicroscopy （CLE） for function repairing of ulcerative colitis （UC）. MethodsThirty patients with UC who were diagnosed and treated in the First Affiliated Hospital of Zhejiang University Medical College between July 2014 and December 2016 were enrolled in the study group. The control group consisted of 10 patients who were diagnosed as having colonic polyps with colonoscopy and underwent polypectomy in the same period. Both groups were examined with white light endoscopy and CLE, then the fluorescein leakage score was compared.ResultsThere were 10 out of 30 cases in the study group whose whole intestinal mucosa were judged as normal under white light endoscopy. In the other 20 cases, there were parts of intestinal mucosa being judged as abnormal. All of the 10 cases in the control group were with normal colon mucosa. There was a significant difference on fluorescein leakage score by CLE between the study group which showed normal by white light endoscopy and the control group （P〈0.05）. The fluorescein leakage score by CLE was significant difference between the abnormal intestinal segment and normal intestinal segment in 20 patients with active UC （P〈0.05）. Spearman correlation analysis showed that there was non-ranked correlation between the fluorescein leakage score of CLE and histopathological findings of biopsy in UC patients with normal mucosa of the left colon under white light endoscopy （rs=0.394, P〉0.05）.Conclusion In the process of mucosal healing of UC patients, structural repair can be found firstly through CLE. Mucosal healing under white light endoscopy cannot represent the functional recovery. CLE is more effective than the histopathology in the evaluation of mucosal barrier function.

关 键 词：结肠炎 溃疡性 内窥镜检查 荧光素类 共聚焦激光显微内镜 黏膜愈合 

分 类 号：R574.62[医药卫生—消化系统]