儿童肠白塞病14例临床特点及消化内镜下特征  

Endoscopic and clinical characteristics of 14 cases of intestinal Behcet′s disease in children

作　　者：于飞鸿[1] 周锦[1] 秦秀敏[1] 韩彤昕[2] 李东丹[1] 梅天璐 房永利 张晶[1] Yu Feihong;Zhou Jin;Qin Xiumin;Han Tongxin;Li Dongdan;Mei Tianlu;Fang Yongli;Zhang Jing(Department of Gastroenterology,Beijing Children′s Hospital Affiliated to Capital Medical University,National Center for Children′s Health,Beijing 100045,China;Department of Rheumatology,Beijing Children′s Hospital Affiliated to Ca-pital Medical University,National Center for Children′s Health,Beijing 100045,China)

机构地区：[1]国家儿童医学中心,首都医科大学附属北京儿童医院消化科,北京100045 [2]国家儿童医学中心,首都医科大学附属北京儿童医院风湿免疫科,北京100045

出　　处：《中华实用儿科临床杂志》2021年第19期1488-1491,共4页Chinese Journal of Applied Clinical Pediatrics

摘　　要：目的总结儿童肠白塞病的临床表现和消化内镜下特征。方法收集2016年1月至2020年3月于首都医科大学附属北京儿童医院消化科住院的儿童肠白塞病14例,对其一般资料、临床表现、实验室检查、影像学检查、消化内镜及组织病理学检查结果进行回顾性分析。结果14例肠白塞病患儿中,男5例,女9例;起病年龄1个月~12岁11个月[(6.68±3.73)岁],中位病程为6个月。14例患儿均有消化道症状,其中腹痛11例,腹泻7例,呕吐2例,并发症包括消化道出血、穿孔、肠道狭窄伴不全性肠梗阻。胃肠道外症状14例患儿均有反复口腔溃疡,其他包括发热11例,皮肤损害9例,血管受累8例,针刺试验阳性6例,关节受累5例,神经系统病变1例,合并营养不良6例。内镜下病变部位以末段回肠[61.5%(8/13例)]、回盲部[53.8%(7/13例)]最常见,镜下表现以溃疡为主,单发溃疡3例,多发溃疡10例,其中深大溃疡7例。内镜病理学活检主要表现为黏膜慢性非特异性炎症、黏膜慢性活动性炎伴溃疡形成、血管炎等。结论儿童肠白塞病的临床表现多样,无特异性,部分患儿可出现严重并发症,内镜下病变有一定特点,消化科医师需提高对本病的认识。Objective To investigate endoscopic and clinical characteristics of intestinal Behcet′s disease(BD)in children.Methods General information,clinical manifestations,laboratory tests,imaging examinations and endoscopic characteristics of 14 children with intestinal BD treated in the Department of Gastroenterology,Beijing Children′s Hospital Affiliated to Capital Medical University from January 2016 to March 2020 were retrospectively analyzed.Results Fourteen children with intestinal BD were recruited,involving 5 males and 9 females with the age of 1 month to 12 years and 11 months[(6.68±3.73)years old],and a median disease course of 6 months.All of them had gastrointestinal symptoms,including 11 cases with abdominal pain,7 cases with diarrhea and 2 cases with vomiting.Complications of children with intestinal BD included gastrointestinal bleeding,intestinal perforation and stenosis.Extragastrointestinal symptoms included recurrent oral aphthosis in all the 14 cases,fever in 11 cases,skin lesions in 9 cases,vascular manifestations in 8 cases,positive pathergy test in 6 cases,joint manifestations in 5 cases,neurological manifestations in 1 case,and malnutrition in 6 cases.Observed by the endoscopy,lesions were mainly distributed in the distal ileum[61.5%(8/13 cases)]and ileocecal part[53.8%(7/13 cases)],with the main manifestation of ulcer.There were 3 cases with single ulcer and 10 cases with multiple ulcers,including 7 cases with deep and large ulcers.Pathological examinations of endoscopic lesions showed that the main features were mucosa chronic nonspecific inflammation,mucosa chronic active inflammation with ulcer and vasculitis.Conclusions Clinical manifestations of intestinal BD vary a lot and are non-specific.Some children with intestinal BD may develop severe complications.Endoscopic lesions of intestinal BD have certain characteristics,which contribute to the diagnosis.Gastroenterologists need to be fully aware of intestinal BD.

关 键 词：肠白塞病 临床表现 内镜特点 儿童 

分 类 号：R725.7[医药卫生—儿科]