肠系膜脂肪增生与克罗恩病疾病行为和活动的关系分析  

The association between mesenteric fat hypertrophy and behavior and activity of Crohn′s disease

作　　者：李林珍 张琰琰 崔秀芳 马晶晶 王迪 张红杰 Li Linzhen;Zhang Yanyan;Cui Xiufang;Ma Jingjing;Wang Di;Zhang Hongjie(Department of Gastroenterology,Jiangsu Province Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China;Department of Ultrasound Diagnosis,Jiangsu Province Hospital,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210000,China)

机构地区：[1]南京医科大学第一附属医院,江苏省人民医院消化内科,210000 [2]南京医科大学第一附属医院,江苏省人民医院超声诊断科,210000

出　　处：《中华内科杂志》2020年第9期711-715,共5页Chinese Journal of Internal Medicine

摘　　要：目的约1/4的克罗恩病(CD)患者存在肠系膜脂肪增生,且可通过腹部超声进行检测。本研究旨在评估肠系膜脂肪增生与CD疾病行为和活动之间的关系。方法本研究共纳入了2018年8月至2019年11月南京医科大学第一附属医院的89例CD患者。根据腹部超声是否检测出肠系膜脂肪增生,分为有肠系膜脂肪增生组和无肠系膜脂肪增生组,分析肠系膜脂肪增生与克罗恩病活动指数(CDAI)、克罗恩病简化内镜评分(SES-CD)、血清学炎性指标以及粪便钙卫蛋白间关系。结果肠系膜脂肪增生与CD狭窄型(B2)存在显著相关(P<0.01)。有肠系膜脂肪增生组的CDAI(P=0.002)、血小板(P=0.001)、C反应蛋白(P=0.024)、粪便钙卫蛋白(P=0.004)、肠壁厚度(P<0.01)均明显高于无增生组,血清白蛋白(P=0.001)明显低于无增生组,差异均有统计学意义。有肠系膜脂肪增生组的红细胞沉降率(P=0.110)、SES-CD(P=0.115)较无增生组有增高趋势,但差异无统计学意义。结论肠系膜脂肪增生与肠腔狭窄有关、与疾病活动有关。Objective Mesenteric fat hypertrophy is present in about a quarter of Crohn′s disease(CD)patients and it can be easily detected by bowel ultrasound(US).The purpose of this research was to assess the correlation between mesenteric fat hypertrophy and behavior and activity of CD.Methods A total of 89 CD patients who admitted to the First Affiliated Hospital of Nanjing Medical University from August 2018 to November 2019 were recruited in this study.The total CD patients were divided into two groups depending on with or without mesenteric fat hypertrophy by US tests.Crohn′s disease activity index(CDAI),simplified endoscopic score for Crohn′s disease(SES-CD),serum inflammatory indicators and fecal calprotectin were assessed.Results Mesenteric fat hypertrophy was significantly associated with stricturing behavior(B2,P<0.01).CDAI(P=0.002),blood platelet(P=0.001),C-reactive protein(P=0.024),fecal calprotectin(P=0.004)and bowel wall thickness(P<0.01)in patients with mesenteric fat hypertrophy were significantly higher than those without,but not the erythrocyte sedimentation rate(P=0.110)and SES-CD(P=0.115).Serum albumin(P=0.001)in patients with mesenteric fat hypertrophy was lower than that in patients without mesenteric fat hypertrophy.Conclusion Mesenteric fat hypertrophy is correlated with intestinal stenosis and disease activity in patients with Crohn′s disease.

关 键 词：肠系膜脂肪 克罗恩病 超声检查 狭窄 

分 类 号：R574.62[医药卫生—消化系统] R572.3[医药卫生—内科学]