经肠镜微探头超声在炎症性肠病分型诊断中的应用价值  

Clinical Value of Transendoscopic Microprobe Ultrasound in the Diagnosis of Inflammatory Bowel Disease

作　　者：王素玲 贾红娥[2] 邓召亮 WANG Suling;JIA Honge;DEGN Zhaoliang(Meixian People's Hospital,Baoji Shaanxi 722300)

机构地区：[1]眉县人民医院功能科,陕西宝鸡722300 [2]延安大学附属医院超声科,陕西延安716000 [3]石泉县中医医院超声科,陕西安康725200

出　　处：《医学临床研究》2023年第11期1720-1722,1726,共4页Journal of Clinical Research

摘　　要：【目的】探讨经肠镜微探头超声(MPS)在炎症性肠病(IBD)分型诊断中的应用价值。【方法】选择2017年3月至2020年3月眉县人民医院收治的84例IBD患者作为观察组,其中溃疡性结肠炎(UC)58例(UC组),克罗恩病(CD)26例(CD组),另选择同期84例体检健康者作为对照组。所有研究对象均接受经肠镜下MPS检查,记录IBD内镜特点,分析MPS鉴别诊断IBD的临床价值。【结果】UC患者在肠镜下MPS多表现为黏膜连续性病变,“鱼嘴”样病变征象发生率高于CD,“象耳”状病变征象发生率低于CD,差异均有统计学意义(P<0.05)。肠镜下MPS判断UC患者Tsuga分型、改良Baron分型的Kappa值分别为0.720、0.815,判断CD患者蒙特利尔疾病行为分型的Kappa值为0.716。三组研究对象病变肠壁总厚度(TWT)、固有肌层(MP)、黏膜下层(SM)及黏膜层(M)水平比较,差异均有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示,M值判断UC的AUC值为0.753(95%CI=0.641~0.864,P<0.001),敏感度为0.862,特异度为0.691。MP值判断CD的AUC值为0.759(95%CI=0.592~0.926,P=0.003)。【结论】经肠镜MPS用于IBD检查有助于CD与UC分型诊断,这对指导IBD患者早期干预具有重要价值。【Objective】To explore the role of transendoscopic microprobe ultrasound(MPS)in the classification and diagnosis of inflammatory bowel disease(IBD).【Methods】A total of 84 patients with IBD admitted to Meixian People's Hospital from March 2017 to March 2020 were selected as the observation group,including 58 cases of ulcerative colitis(UC)(UC group)and 26 cases of Crohn's disease(CD)(CD group).Another 84 healthy individuals who underwent physical examination during the same period were selected as the control group.All subjects underwent transendoscopic MPS examination,recorded the endoscopic characteristics of IBD,and analyzed the clinical value of MPS in differential diagnosis of IBD.【Results】The MPS findings of UC patients under endoscopy showed a continuous distribution of mucosal lesions,with a higher incidence of"fish mouth"lesions than CD,and a lower incidence of"ear-like"lesions than CD,with significant statistical differences(P<0.05).The Kappa values of MPS for Tsuga classification and modified Baron classification in UC patients were 0.720 and 0.815,respectively,while the Kappa value for Montreal disease behavior classification in CD patients was 0.716.The comparison of total wall thickness(TWT),muscularis propria(MP),submucosa(SM),and mucosa(M)levels among the three groups showed significant statistical differences(P<0.05).The receiver operating characteristic(ROC)curve analysis showed that the AUC value of M value for UC was 0.753(95%CI=0.641-0.864,P<0.001),with a sensitivity of 0.862 and a specificity of 0.691.The AUC value of MP value for CD was 0.759(95%CI=0.592-0.926,P=0.003).【Conclusion】Transendoscopic MPS for IBD examination is helpful for the classification and diagnosis of CD and UC,which is of great value in guiding early intervention for IBD patients.

关 键 词：炎性肠疾病/影像诊断 直肠镜检查 

分 类 号：R574[医药卫生—消化系统]