| 杨黄欢,邓中民,危贵君,邱雷,陆会飞.结肠镜联合内镜超声检查对克罗恩病病情评估的价值研究[J].浙江中西医结合杂志,2023,33(8): |
| 结肠镜联合内镜超声检查对克罗恩病病情评估的价值研究 |
| Clinical Value of colonoscopy combined with Endoscopic Ultrasonography in the Evaluation of Crohn’s disease |
| 投稿时间：2023-02-23 修订日期：2023-08-03 |
| DOI： |
| 中文关键词: 克罗恩病 内镜超声检查 结肠镜检查 |
| 英文关键词:Crohn’s disease Endoscopic Ultrasonography colonoscopy |
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| 中文摘要: |
| 摘要： 目的 探究内镜超声（EUS）联合结肠镜检查在评估克罗恩病（CD）严重程度中的一致性和互补性。 方法 回顾性分析符合诊断标准的89例CD患者的疾病临床活动程度，并与其白光内镜和内镜超声下表现进行相关性研究。 结果 根据疾病临床活动度分为：轻度活动期30例，中度活动期48例，重度活动期11例，CD内镜下严重程度指数和疾病临床活动度呈显著正相关（P＜0.01）; 内镜超声下CD肠壁表现为非连续性非对称性增厚，平均7.92±0.98mm,以黏膜下层和固有肌层增厚为主，平均厚度分别为4.31±0.43mm、2.18±0.51mm，黏膜层增厚不明显,平均厚度1.58±0.35mm; CD患者肠壁总厚度，黏膜下层及固有肌层厚度均和疾病活动度呈显著正相关（P＜0.01），黏膜层在重度患者中则明显增厚；随着CD患者疾病活动度的加重，肠壁各层次间清晰度会发生变化，粘膜下层/固有肌层界限可辨率随疾病加重明显降低（P＜0.01），黏膜层/黏膜下层界限可辨率在轻、中度之间无明显差异，重度患者则明显降低。 结论 结肠镜检查及内镜下评分可对CD严重程度进行评估，内镜超声检查可通过肠壁厚度和层次间清晰度变化评估CD病情严重程度。结肠镜联合内镜超声检查可互补提升CD内镜下诊断效率和精准度。 |
| 英文摘要: |
| Abstract：Objective To investigate the consistency and complementarity of endoscopic ultrasonography（EUS）combined with colonoscopy in evaluation of Crohn’s disease. Methods The clinical activity of 89 CD patients who met the diagnostic criteria was analyzed retrospectively,and the correlation between the clinical activity and its manifestations under colonoscopy and EUS was studied Results According to the degree of disease activity :30 cases were classified as mild，48 moderate ,11 severe，There was a significant positive correlation between CD simple endoscopic score and disease activity（P＜0.01）；Under EUS, the intestinal wall of CD showed discontinuous and asymmetric thickening, with an average thickness of 7.92±0.98mm, mainly the submucosa and muscularis propria thickening，The average thickness was 4.31±0.43mm and 2.18±0.51mm, respectively，There was no obvious thickening of mucosa, with an average thickness of 1.58±0.35mm;The total thickness of intestinal wall, submucosal and muscularis propria layer were significantly positively correlated with disease activity in CD patients (P < 0.01).The mucosa thickens significantly in severe patients.With the increase of disease activity in CD patients, the clarity between different levels of the intestinal wall will change，The discernibility of the submucosal/muscularis propria boundary decreased significantly with disease progression(P < 0.01).There was no significant difference in the discernibility of mucosal/submucosal boundary between mild and moderate patients, but significantly decreased in severe patients. Conclusions The severity of CD can be evaluated by colonoscopy and endoscopic score，Endoscopic ultrasonography can assess the severity of CD by changes in wall thickness and interlayer clarity.Colonoscopy combined with EUS can improve the diagnostic efficiency and accuracy of CD. |
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