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克罗恩病与肠结核的临床表现和内镜及CT特征分析
引用本文:朱庆强,吴晶涛,陈文新,征锦,陈明祥,罗先富.克罗恩病与肠结核的临床表现和内镜及CT特征分析[J].中华全科医师杂志,2012(10):765-769.
作者姓名:朱庆强  吴晶涛  陈文新  征锦  陈明祥  罗先富
作者单位:江苏省苏北人民医院医学影像科,扬州225001
基金项目:江苏省苏北人民医院重点院级基金项目(YZUCMS201203)
摘    要:回顾性分析经病理检查确诊的39例克罗恩病(CD)与24例肠结核(ITB)患者的临床、内镜及CT特点。结果显示,CD组腹泻、便血、肛周疾病、肠梗阻等明显高于ITB组(P〈0.05或0.01);ITB组发热、盗汗症状及伴肺结核、腹水发生率明显高于CD组(均P〈0.01)。内镜下CD患者纵形溃疡、鹅卵石征、肠腔狭窄表现均较ITB组多见(P〈0.05或0.01),而ITB的环形溃疡、鼠咬状溃疡较CD组多见(P〈0.05或0.01)。CT下CD组肠壁分层状增厚、肠壁内积气、肠壁脂肪征、肠腔狭窄、腹腔脓肿表现均较ITB组多见(P〈0.05或0.01),而ITB肠壁单层状增厚、中空淋巴结较CD组多见(P〈0.01);ITB组肠壁增厚、强化及淋巴结肿大的程度多均高于CD组(均P〈0.01)。提示CD与ITB各有其临床特点,结合内镜及CT下表现特点有助于二者的鉴别诊断。

关 键 词:Crohn病  结核    胃肠

Differential diagnosis between Crohn's disease and intestinal tuberculosis based on clinical manifestations, endoscopic and CT findings
ZHU Qing-qiang,WU Jing-tao,CHEN Wen-xin,ZHENG Jin,CHEN Ming-xiang,LUO Xian-fu.Differential diagnosis between Crohn's disease and intestinal tuberculosis based on clinical manifestations, endoscopic and CT findings[J].Chinese JOurnal of General Practitioners,2012(10):765-769.
Authors:ZHU Qing-qiang  WU Jing-tao  CHEN Wen-xin  ZHENG Jin  CHEN Ming-xiang  LUO Xian-fu
Institution:( Department of Medical Imaging, Subei People's Hospital, Yangzhou 225001, China)
Abstract:The clinical data, endoscopic and CT findings of 39 patients with Crohn's disease(CD) and 24 patients with intestinal tuberculosis (ITB) were retrospectively reviewed. Diarrhea, hematochezia, perianal disease, intestinal obstruction, occurred more frequently in CD than in ITB (P 〈 0. 05 or 〈 0. 01 ). Night sweating, febrility, pulmonary tuberculosis and ascites were more common in ITB than in CD (P 〈 0. 01 ). The endoscopic findings showed that longitudinal ulcer, cobblestone sign, intestinal stricture were detected more often in CD than in ITB ( P 〈 0. 05 or 〈 0. 01 ) , but transverse ulcer and rodent ulcer were more frequently found in ITB than in CD (P 〈0. 05 or 〈0. 01 ). On the CT imaging mural gas, fat, enteric cavity stenosis and layering thickening were more common in CD than in ITB ( P 〈 0. 05 or 〈 0. 01 ) , but mural single layer thickening and hollow lymph nodes were discovered more frequently in ITB than in CD (P 〈0. 01 ). The degree of intestinal wall thickening, enhancement and lymph nodes enlargement of ITB were more severe than that of CD (P 〈 0. 01 ). The clinical manifestations combined with endoscopic and CT finding may improve the differential diagnosis between Crohn's disease and intestinal tuberculosis.
Keywords:Crohn disease  Tuberculosis  gastrointestinal
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