肠白塞病的内镜特点与临床特征分析  

Analysis of endoscopic and clinical characteristics of intestinal Behcet′s disease

作　　者：卢雪扬 刘冰熔[1] 刘丹[1] 林锐[1] LU Xueyang;LIU Bingrong;LIU Dan;LIN Rui(Department of Gastroenterology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院消化内科,河南郑州450052

出　　处：《胃肠病学和肝病学杂志》2023年第9期972-976,981,共6页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的分析白塞病消化道内镜下表现与临床特点,以提高消化道受累的白塞病的诊治水平。方法收集2013年1月至2021年12月于郑州大学第一附属医院收治的肠白塞病患者,回顾性分析内镜下特征、一般资料、临床表现、实验室检查和病理学检查结果等临床资料。结果共纳入肠白塞病患者67例,男女比例为1.2∶1,发病年龄(31±15)岁,中位病程5年(7 d~40年)。66例有消化道症状,腹痛是最常见症状,其中半数以上(53.8%)为右下腹痛。内镜表现以溃疡为主,以回盲区最为常见,30例(44.8%)患者同时多部位消化道受累,1例(1.5%)仅小肠受累。病理学检查提示7例(10.6%)存在血管炎。直肠受累患者的红细胞沉降率显著高于直肠未受累患者[(50.6±32.9)mm/h vs(24.0±20.0)mm/h,P=0.001],下消化道受累患者的血红蛋白水平显著低于上消化道受累患者[(103.6±22.7)g/L vs(131.2±17.7)g/L,P=0.001]。40岁及以上患者的内镜下多发溃疡发生率高(77.8%vs 51.0%,P=0.049),深大溃疡发生率低(11.1%vs 36.7%,P=0.042)。结论白塞病的消化道表现多样,回盲区溃疡是最常见的临床特征,需进行全面的内镜评估,完善胶囊内镜检查,长期随访,避免漏诊。部分内镜下表现与该病的临床特点密切相关。Objective To analyze the endoscopic characteristics and clinical manifestations of Behcet′s disease,and to improve the diagnosis and treatment of Behcet′s disease with digestive tract involvement.Methods From Jan.2013 to Dec.2021,the Behcet′s disease patients with digestive tract involvement admitted in the First Affiliated Hospital of Zhengzhou University were collected.The clinical data including endoscopic characteristics,baseline demographic characteristics,clinical manifestations,laboratory examinations and pathological findings were analyzed retrospectively.Results A total of 67 Behcet′s disease patients with gastrointestinal involvement were included.The male to female ratio was 1.2∶1.The onset age was(31±15)years old,and the median disease duration was 5 years(7 days to 40 years).Sixty-six cases had gastrointestinal symptoms.Abdominal pain was the most common symptom,and more than half(53.8%)of them were right lower abdominal pain.Endoscopic characteristic was mainly ulcer,mostly in the ileocecal area.Thirty patients(44.8%)had multiple digestive tract involvement,and 1 patient(1.5%)only had small intestine involvement.Pathological findings revealed vasculitis in 7 cases(10.6%).Erythrocyte sedimentation rate in patients with rectal involvement was significantly higher than that in patients without rectal involvement[(50.6±32.9)mm/h vs(24.0±20.0)mm/h,P=0.001].Hemoglobin levels in patients with lower gastrointestinal tract involvement were significantly lower than those in patients with upper gastrointestinal tract involvement[(103.6±22.7)g/L vs(131.2±17.7)g/L,P=0.001].The incidence of multiple ulcers in patients≥40 years old was higher(77.8%vs 51.0%,P=0.049),while the incidence of deep ulcers was lower(11.1%vs 36.7%,P=0.042).Conclusion Behcet′s disease has multiple gastrointestinal manifestations,and the most frequent endoscopic symptom is ileal ulceration.In order to reduce the false negative rate,we need to conduct a comprehensive endoscopic evaluation,capsule endoscopy and long-term fo

关 键 词：肠白塞病 临床表现 内镜特点 诊断 

分 类 号：R574[医药卫生—消化系统]