原发性硬化性胆管炎患者炎症性肠病和胆囊息肉发生率分析  

Incidences of inflammatory bowel disease and gallbladder polyps in patients with primary sclerosing cholangitis

作　　者：毛帅[1] 黄春龙[1] 陈保民 Mao Shuai;Huang Chunlong;Chen Baomin(Department of Hepatobiliary Surgery,Eastern Branch,First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510000,Guangdong Province,China)

机构地区：[1]中山大学附属第一医院东院肝胆外科

出　　处：《实用肝脏病杂志》2020年第2期296-299,共4页Journal of Practical Hepatology

基　　金：广东省科技厅科技发展计划项目(编号:2016A020215189)

摘　　要：目的对原发性硬化性胆管炎(PSC)患者炎症性肠病(IBD)和胆囊息肉(GP)发生情况进行回顾性分析。方法2000年1月~2018年12月我院收治的201例PSC患者,经内镜逆行胰胆管造影(ERCP)和磁共振胰胆管造影(MRCP)诊断,经腹部CT或腹部超声或肠镜检查证实GP和IBD存在。结果在201例PSC患者中检出GP 23例(11.4%)和IBD 154例(76.6%);在23例GP患者中,IBD、溃疡性结肠炎(UC)和克罗恩病(CD)发生率分别为87.0%、73.9%和8.7%,在178例无GP患者中,则分别为75.3%、58.4%和15.7%,无显著统计学差异(P>0.05);15例GP患者接受了胆囊切除术,术后组织病理学检查提示5例(33.3%)为腺癌,3例(20.0%)为高度不典型增生,另7例为良性病变,良性与恶性病变患者临床资料比较无统计学差异(P>0.05)。结论PSC患者GP和IBD发病率很高,其中部分GP可进展为恶性病变,宜早期手术治疗。Objective The aim of this study was to investigate the incidences of inflammatory bowel disease(IBD)and gallbladder polyp(GP)in patients with primary sclerosing cholangitis(PSC).Methods The clinical data of 201 patients with PSC in Eastern Branch of the First Hospital affiliated to Sun Yat-sen University between January 2000 and December 2018 were retrospectively analyzed.The diagnosis of PSC was based on endoscopic retrograde cholangiopancreatography(ERCP)and magnetic resonance cholangiopancreatography(MRCP),and the presence of GP and IBD were confirmed by abdominal CT,abdominal ultrasound or enteroscopy.Results A total of 23 patients(11.4%)with GP and 154(76.6%)with IBC were found out of this 201 cases with PSC;in 23 patients having GP,the incidences of IBD,ulcerative colitis(UC)and Crohn's disease(CD)were 87.0%,73.9%and 8.7%,and in 178 patients without GP,they were 75.3%,58.4%and 15.7%,not significant differences between the two groups(P>0.05);15 patients with GP underwent cholecystectomy,and the histopathological examination post-operationally demonstrated that 5(33.3%)were adenocarcinoma,3(20.0%)were advanced atypical hyperplasia and another 7 belonged to benign polyp;the clinical data between patients with benign and malignant lesions were not significantly different(P>0.05).Conclusions GP and IBD are common lesions in patients with PSC,and the reason of these complications occurrence is not clear.The GP in patients with PSC,even a small polyp,has a risk of developing malignant tumors,which warrants early cholecystectomy as sooner as possible.

关 键 词：原发性硬化性胆管炎 胆囊息肉 炎症性肠病 恶变 

分 类 号：R574[医药卫生—消化系统] R575.6[医药卫生—内科学]