25例肠白塞病患者临床特征分析  

Clinical Characteristics Analysis of 25 Patients With Intestinal Behçet′s Disease

作　　者：杨青林 万俊辰 王华岗 周琦[1] YANG Qinglin;WAN Junchen;WANG Huagang;ZHOU Qi(Department of Gastroenterology,Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030)

机构地区：[1]华中科技大学同济医学院附属同济医院消化内科,430030

出　　处：《胃肠病学》2024年第3期174-179,共6页Chinese Journal of Gastroenterology

摘　　要：背景:肠白塞病是一种全身多系统血管炎性疾病的肠道受累亚型,可导致严重的肠道和肠外并发症,增加住院率,降低患者生活质量。目的:分析肠白塞病患者的临床、内镜和病理特征。方法:选取2018年4月—2023年4月华中科技大学同济医学院附属同济医院收治的25例肠白塞病患者,回顾性分析患者的基本资料、临床症状和体征、内镜和实验室检查结果以及治疗方案。结果:在25例肠白塞病患者中,男性12例,女性13例;发病中位年龄为37岁。口腔溃疡发生率为72.0%,其中60.0%的患者以口腔溃疡为首发症状。确诊前,60.0%的患者有腹痛症状,12.0%有胸骨后疼痛或不适。所有患者内镜下均可见回盲部溃疡,其中典型溃疡15例,非典型溃疡10例,两组性别分布差异有统计学意义(P=0.041 4)。典型溃疡患者的肠白塞病疾病活动指数(DAIBD)评分明显高于非典型溃疡患者(P=0.019 4),而中性粒细胞计数、血红蛋白、超敏C反应蛋白、γ-谷氨酰转移酶的两组间差异均无统计学意义(P>0.05)。5例患者合并食管溃疡。5例患者在病程中升级为生物制剂治疗(阿达木单抗或英夫利西单抗)。4例典型溃疡患者因肠穿孔、消化道出血或肛瘘接受外科手术治疗。结论:性别、DAIBD评分与肠白塞病患者的回盲部典型溃疡存在一定相关性。Background:Intestinal Behçet′s disease is a subtype of multisystem vasculitis that affects the intestine,leading to severe intestinal and extra⁃intestinal complications,increased hospitalization rate,and a decrease in the quality of life of patients.Aims:To analyze the clinical,endoscopic,and pathological characteristics of patients with intestinal Behçet′s disease.Methods:Twenty⁃five patients with intestinal Behçet′s disease admitted from April 2018 to April 2023 at Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology were enrolled.The demographic data,clinical symptoms and signs,endoscopic findings,laboratory results,and therapeutic strategies were retrospectively analyzed.Results:In 25 patients with intestinal Behçet′s disease enrolled in this study,12 were males and 13 females,with a median age of onset at 37 years old.Oral ulcer was reported in 72.0%of patients,with 60.0%presenting with oral ulcer as the initial manifestation.Before diagnosis,60.0%of patients suffered from abdominal pain,and 12.0%experienced retrosternal pain or discomfort.All patients presented with ileocecal ulcer under endoscopy,with 15 cases of typical ulcer and 10 cases of atypical ulcer.The difference in gender distribution was statistically significant between the two groups(P=0.0414).The disease activity index for intestinal Behçet′s disease(DAIBD)in typical ulcer group was significantly higher than that in atypical ulcer group(P=0.0194),while no significant differences in neutrophil count,hemoglobin,hypersensitive C⁃reactive protein,andγ⁃glutamyl transferase were found between the two groups(P>0.05).Five patients were accompanied with esophageal ulcer.During the course of the disease,5 patients escalated to biological therapy(adalimumab or infliximab).Four patients with typical ulcer underwent surgical treatment due to complications such as intestinal perforation,gastrointestinal bleeding,and anal fistula.Conclusions:There exists a significant association between gender,DAIB

关 键 词：肠白塞病 溃疡 内镜检查 诊断 治疗 

分 类 号：R574[医药卫生—消化系统]