小肠CT成像对克罗恩病活动性的评估价值  

The value of CT enterography in evaluating activity of Crohn′s disease

作　　者：肖军华 贺志龙[1] 陈冰心[1] 柳堤 黎文华 XIAO Jun-hua;HE Zhi-long;CHEN Bing-xin;LIU Di;LI Wen-hua(Department of Gastroenterology,The First Affiliated Hospital of Soochow University,Suzhou,Jiangsu,215006,China)

机构地区：[1]苏州大学附属第一医院消化内科,江苏苏州215006 [2]上海市嘉定区江桥医院消化内科,上海201803

出　　处：《中国临床研究》2021年第3期333-336,共4页Chinese Journal of Clinical Research

基　　金：江苏省自然科学基金青年基金(BK20170372)。

摘　　要：目的评估小肠CT成像(CTE)与克罗恩病临床症状之间的相关性。方法收集2016年9月至2019年9月60例克罗恩病患者CTE数据,并对患者的临床参数进行回顾性分析。其中CTE参数包括:肠壁增厚和强化,肠系膜脂肪增生,血管增多和并发症(瘘管、狭窄、脓肿)。克罗恩病疾病活动性评估采用克罗恩病活动指数(CDAI)和临床生化标记物(C反应蛋白、红细胞沉降率、血小板、血红蛋白)。利用回归参数分析CTE参数、临床活动指数及实验室参数之间的相关性。结果CDAI增加与脂肪密度增加(P=0.03)、肠道狭窄(P=0.04)、梳状症(P=0.01)有关。ESR升高与肠系膜淋巴结增大(P=0.04)和黏膜强化(P=0.01)相关。结论CTE显示肠周炎症(脂肪密度增加)表现和梳状症的克罗恩病患者,临床疾病处于活动,需要更积极的治疗方案。Objective To assess the correlation between computed tomography enterography(CTE)and clinical features of Crohn′s disease.Methods The CTE data from 60 patients with Crohn′s disease from September 2016 to September 2019 were collected.And the clinical parameters were retrospectively analyzed.The CTE parameters include:thickening and strengthening of the intestinal wall,mesenteric fatty hyperplasia,increased blood vessels and complications(fistula,stenosis,abscess).The disease activity of Crohn′s disease was assessed by Crohn′s disease activity index(CDAI)and clinical biochemical markers(C-reactive protein,erythrocyte sedimentation rate,platelets,hemoglobin).Multiple linear regression was used to analyze the correlation between CTE parameters,clinical activity index and laboratory parameters.Results The increased CDAI was significantly related to fat density(P=0.03),intestinal stenosis(P=0.04),and pectinopathy(P=0.01).Increased ESR was associated with enlarged mesenteric lymph nodes(P=0.04)and mucosal enhancement(P=0.01).Conclusion Crohn′s disease patients with peri-intestinal inflammation(increased fat density)manifestations and pectinopathy with CTE are clinically active and require more aggressive treatment.

关 键 词：克罗恩病 小肠CT成像 克罗恩疾病活动指数 

分 类 号：R574.62[医药卫生—消化系统] R445.2[医药卫生—内科学]