巨细胞病毒大肠炎的临床特征分析  

Clinical characteristics of cytomegalovirus colitis

作　　者：张馨梅 赵有财[2] 张振玉[1] ZHANG Xinmei;ZHAO Youcai;ZHANG Zhenyu(Department of Gastroenterology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China;Department of Pathology,Nanjing First Hospital,Nanjing Medical University,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)消化科,江苏南京210006 [2]南京医科大学附属南京医院(南京市第一医院)病理科,江苏南京210006

出　　处：《胃肠病学和肝病学杂志》2019年第7期786-790,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨巨细胞病毒(cytomegalovirus,CMV)大肠炎患者的临床特点及疾病转归。方法收集南京市第一医院2012年1月1日至2018年10月31日16例经病理确诊的CMV大肠炎患者的疾病背景、临床表现、内镜及病理特征,治疗及转归情况进行回顾性分析。结果16例CMV大肠炎患者中,免疫缺陷者6例,免疫健全者10例;炎症性肠病(inflammatory bowel disease,IBD)患者10例,非IBD患者6例。免疫健全组及非IBD组平均年龄偏高,差异无统计学意义(P>0.05)。各基础疾病在免疫健全组及免疫缺陷组中的分布差异无统计学意义(P>0.05)。CMV肠炎的临床表现及内镜表现多样。IBD患者合并CMV肠炎者腹泻比例显著高于非IBD患者(P<0.05)。溃疡性结肠炎(UC)患者合并CMV时可出现不典型的黏膜形态。抗病毒治疗总缓解率为86.7%。结论免疫缺陷者与免疫健全者均可发生CMV大肠炎,IBD为CMV大肠炎的易感人群。特征性的内镜表现有助于诊断CMV大肠炎。早期抗病毒治疗有效率高。Objective To investigate the clinical characteristics and prognosis of cytomegalovirus (CMV) colitis. Methods A retrospective study was performed involving 16 CMV colitis patients in Nanjing First Hospital from Jan.1st,2012 to Oct.31st,2018.The patients’ demographic data,underlying diseases,clinical features,endoscopic and pathologic findings,treatment regimens and outcome were analyzed. Results Among the 16 CMV colitis patients,there were 6 immunodeficient patients and 10 immunocompetent patients,10 inflammatory bowel disease (IBD) patients and 6 non-IBD patients.The immunocompetent patients and non-IBD patients were older,but without statistical significance( P >0.05 ).There was no difference in the rate of underlying chronic diseases between immunocompetent patients and immunodeficient patients( P >0.05).The clinical manifestations mainly included abdominal pain,diarrhea,bloody stool and fever.IBD patients had a significant higher rate of diarrhea ( P <0.05).The mucosal appearance of CMV colitis was multiform.Untypical mucosal defects were seen in ulcerative colitis (UC) patients with CMV infection.The efficacy rate of antivirus therapy for CMV colitis was 86.7%. Conclusion CMV colitis could happen in both immunocompetent and immunodeficient patients.IBD patients are susceptible to CMV infection.Characteristic endoscopic manifestations could suggest the diagnosis of CMV colitis.Early antiviral treatment is recommended for its high efficacy rate in CMV colitis.

关 键 词：巨细胞病毒性大肠炎 炎症性肠病 临床特征 

分 类 号：R574.6[医药卫生—消化系统]