载脂蛋白M在炎症性肠病中的测定及意义

目的 探讨血清载脂蛋白M (apolipoprotein M,apoM)在炎症性肠病(inflammatory bowel disease,IBD)患者血清中的表达及意义。方法 采用双抗夹心酶联免疫吸附法(enzyme-linked immuno sorbent assay,ELISA)检测101例IBD患者及69例健康对照组的血清apoM和肿瘤坏死因子a(tumor necrosis factor-a,TNF-α)水平,分析其与IBD疾病活动度的相关性。结果 溃疡性结肠炎(ulcerative colitis,UC)组、克罗恩病(Crohn＇s disesse,CD)组和健康对照组的血清apoM水平分别为(13.5±8.8) mg/L,(10.2±5.8) mg/L和(2.0±1.3) mg/L,且UC组血清apoM水平高于CD组,差异有统计学意义(P＜0.05);UC和CD患者血清apoM水平均随着疾病活动度的增加而升高,各等级间差异有统计学意义(P＜0.05);IBD组血清apoM水平与血清TNF-α水平呈正相关(r=0.314,P=0.001),以CD组为著(r=0.365,P=0.010)。结论 UC、CD患者血清apoM水平与疾病活动度相关,在评估IBD疾病活动度上有潜在的运用价值。     

与炎症性肠病病情活动相关的因素

炎症性肠病(IBD)是一组病因未明的非特异性肠道炎症,包括克罗恩病(CD)和溃疡性结肠炎(UC)。由于IBD临床表现复杂多变,诊断缺乏特异性的指标,常因对病情活动的判断不及时而延误治疗。现将与炎症性肠病病情活动相关的因素综述如下,旨在为临床监测疾病的活动性提供依据。1与疾病活     

未确定型炎症性肠病的临床特征分析

【目的】通过对未确定型炎症性肠病患者的临床特征进行分析加深对该型炎性肠病的认识。【方法】对2001年3月至2008年12月期间住院病人中符合炎性肠病的258例患者的临床特点进行回顾性分组分析。【结果】258例患者中未确定型炎性肠病32例（12．4％）,克罗恩病（CD）71例（27．5％）,溃疡性结肠炎（UC）155例（60．1％）。首发症状为腹泻、粘性血便、腹痛和发热。【结论】与克罗恩病及溃疡性结肠炎相比未确定型炎性肠病有一些自己的特点,有可能是一个独立病变。     

免疫抑制剂在炎症性肠病治疗中的应用进展

炎症性肠病包括溃疡性结肠炎和克罗恩病,是病因尚不十分明确的肠道慢性反复的非特异性炎症。免疫抑制剂是重要的药物治疗方法,维持无激素长期缓解,主要用于克罗恩病和激素依赖或抵抗的溃疡性结肠炎的维持治疗。常用的免疫抑制剂包括硫嘌呤类、甲氨蝶呤、环孢素等药物。     

Claudin-4在炎症性肠病小鼠结肠黏膜中的表达及意义

目的观察claudin-4在葡聚糖硫酸钠(DSS)诱导的小鼠炎症性肠病(IBD)模型中的表达,探讨claudin-4在IBD发病机制中的作用。方法对14只C57BL/6小鼠采用2.5%DSS持续经饮水途径饲养7 d建立IBD模型,另取6只作对照,自由饮水,于第8天观察结肠组织病理学变化,应用免疫组织化学染色,免疫印迹检测结肠黏膜中claudin-4的表达。结果模型组体质量变化、病理学改变证实造模成功。与对照组比较,模型组小鼠的claudin-4表达显著减少,差异有统计学意义(P0.05)。结论 Claudin-4在IBD小鼠结肠黏膜中表达下降,可能在IBD发病中起到重要作用。     

自我管理理论在炎症性肠病患者中的应用研究进展

炎症性肠病(inflammatory bowel disease,IBD)是一种病因尚不明确的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn disease,CD)。其病程迁延,易反复发作,具有癌变倾向,被WHO列为现代难治病之一。加之患者生理、心理、社会、情感等功能均有不同程度的下降[1],IBD患者疾病负担重,个人生活质量受到严重影响。据2007年WHO统计[2],IBD发病率仅次于风湿性关节炎,位于慢性病发病率第2位,是全球性的疑难疾病。我国UC与CD的患病率无确切统计数     

机会性感染与炎症性肠病

免疫抑制剂和生物制剂的应用为炎症性肠病（inflammatory bowel disease, IBD）的治疗打开了一扇门,但同时增加了机会性感染的风险。其常见病原学包括病毒、细菌、真菌及寄生虫等。机会性感染增加了IBD患者的致死率和致残率,降低了患者的生活质量。因此,IBD治疗过程中,早期发现、识别IBD合并的机会性感染以及早期采取措施治疗或预防性治疗极其重要。     

幽门螺杆菌与炎症性肠病

近年来,炎症性肠病(inflammatory bowel disease, IBD)的发病率呈逐年上升趋势,但其病因尚不十分清楚,目前认为与遗传、免疫、感染及环境等多种因素密切相关。幽门螺杆菌（H.pylori）是胃内一种常见的革兰阴性微需氧菌,与消化性溃疡及消化道肿瘤密切相关。H.pylori与IBD是否存在相关性尚无定论。本文就H.pylori与IBD的关系进行综述,以期对IBD病因有更加深入的了解,也为临床治疗IBD提供新的思路。     

内镜在炎症性肠病中的作用

内镜在炎症性肠病的诊治中发挥着至关重要的作用,它是炎症性肠病诊断和鉴别诊断最重要的手段,能够针对病情和术后复发风险、黏膜愈合等方面进行评估,并进行炎症性肠病相关结直肠癌的筛查与监测,针对狭窄、出血和瘘管等并发症和原发性硬化性胆管炎、胆管癌等进行相应镜下治疗。     

肠道菌群与炎症性肠病

炎症性肠病(IBD)是发生于胃肠道的慢性复发性疾病,克罗恩病(CD)和溃疡性结肠炎(UC)为其两种主要表现形式,其致病因素及发病机制至今尚未完全阐明,但目前普遍认为IBD是由遗传因素、免疫功能紊乱、肠道屏障功能障碍和肠道菌群改变等多因素所致。随着16S rRNA基因检测技术的应用及肠道微生物宏基因组学计划的开展,人们对肠道微生物——"被遗忘的器官"有了更深刻的认识,其在IBD中的重要作用也逐渐被重视。研究认为IBD患者中宿主与肠道微生物之间精确的平衡关系被打破,从而触发了基因易感个体的免疫炎症反应。因此,调节肠道菌群紊乱,恢复宿主与肠道微生物之间的稳态成为治疗IBD的一个新方向。本文就IBD患者中存在的肠道菌群紊乱现象、其与IBD发病的关系以及微生态制剂在IBD治疗中的应用做一简要综述。     

IgG subclasses of anti Saccharomyces cerevisiae antibody in inflammatory bowel disease

Elevation of serum anti Saccharomyces cerevisiae antibody (ASCA) has been reported in patients with Crohn's disease. We analysed the subclasses of Immunoglobulin (Ig) G reaction in ASCA in sera from patients with inflammatory bowel disease, healthy controls, and patients with intestinal Behçet's disease. Serum samples were obtained from 29 patients with Crohn's disease, 30 patients with ulcerative colitis, 7 patients with intestinal Behçet's disease, and 12 healthy controls. Serum IgG subclasses IgG1, IgG2, IgG3, and IgG4 of ASCA were analysed using ELISA. IgG4 ASCA was significantly increased in patients with inflammatory bowel disease. In patients with intestinal Behçet's disease, IgG1, IgG3, and IgG4 ASCA were increased. Differential responses, in terms of subclasses in ASCA, were found in patients with inflammatory bowel disease and patients with intestinal Behçet's disease, which may represent different pathophysiologies of these intestinal inflammatory diseases.     

血小板相关参数对评估炎症性肠病活动性的临床意义

目的探讨血小板相关参数评估炎症性肠病(IBD)活动性的价值。方法回顾性收集2010年1月至2019年6月九江学院附属医院消化内科住院的溃疡性结肠炎(UC)及克罗恩病(CD)患者共206例,另选取于九江学院附属医院健康体检50例健康人员作为对照;收集研究对象临床资料,并依据病史、Myao活动指数、蒙特利尔分级及克罗恩病活动指数(CDAI)对患者进行分组及疾病严重程度分级。收集患者首次诊断时的血常规检测指标。结果IBD患者的血小板相关参数除P-LCR外与对照组比较均有明显差异(P<0.05);CD患者PCT及PLT显著高于UC(P分别0.007、<0.001);IBD活动期患者血小板参数与对照组存在显著差异(P<0.05);且UC患者病情与血小板参数存在相关性,重度患者PLT高于轻度患者(P<0.05)、MPV低于轻度患者(P=0.001);将MPV、PDW、P-LCR、PCT、PLT联合诊断IBD的活动性,得到AUC=0.857,95%CI 0.803~0.912,P<0.05。结论MPV、PDW在IBD活动期降低;PLT、PCT则增高;血小板相关参数联合诊断可较好反映IBD活动性。     

经腹肠道超声在炎症性肠病诊断中的应用及进展

炎症性肠病(IBD)是一种慢性炎症性疾病,病程漫长,症状发作与缓解反复交替,通常需要终身治疗。经腹肠道超声(TUBS)已成为临床IBD疑诊患者筛查的首选影像技术,对确定IBD病变的部位和范围、发现腹部并发症、评估炎症活动性及治疗后随访均有很高的敏感度和特异度。口服肠道超声造影、经静脉超声造影等超声新技术扩大了TBUS在IBD中的应用能力;而新兴的超声分子成像技术更有望使TBUS在疾病早期诊断上取得突破。     

联合检测炎症性肠病患者抗酿酒酵母细胞抗体和抗中性粒细胞抗体的临床意义

目的 探讨联合检测炎症性肠病(IBD)患者血清中抗酿酒酵母细胞抗体(ASCA)和抗中性粒细胞胞浆抗体(ANCA)对IBD诊断和鉴别诊断的应用价值.方法 用ELISA法和间接免疫荧光法分别测定159例IBD患者[溃疡性结肠炎(UC)97例,克罗恩病(CD)62例],167例主诉为腹痛、腹泻并除外IBD的患者和25名健康人血清中IgG型与IgA型ASCA和ANCA.结果 ASCA-IgA/IgG在CD组、UC组、疾病对照组和健康对照组中的阳性率分别为43.5%、14.4%、29.3%和0;CD组的阳性率显著高于UC组和疾病对照组(X2值分别为16.76、4.12,P分别<0.01、<0.05).ANCA在以上各组中的阳性率分别为8.1%、56.7%、4.8%和0;UC组中阳性率显著高于CD组和疾病对照组(X2值分别为38.08、90.47,P均<0.01);ASCA+/ANCA-组合诊断CD的敏感度、特异度、阳性预测值分别为40.3%,93.8%和80.6%;而ANCA+/ASCA-组合诊断UC的敏感度、特异度和阳性预测值分别为48.5%,98.4%和97.9%;ASCA在手术治疗与未手术治疗CD患者中的阳性率差异具有统计学意义(P=0.03).结论 ASCA或ANCA单项检测不能有效的筛选IBD患者,但2项指标联合检测有助于对UC和CD进行鉴别诊断.同时检测IgA型和IgG型ASCA可提高CD诊断的敏感度.中国人群中ASCA阳性可能与手术治疗相关.     

MR colonography in inflammatory bowel disease

Colonography based on magnetic resonance imaging (MRI) appears to be a promising technique for polyp assessment in the colon. Several studies have evaluated this method for colonic assessment in patients with inflammatory bowel disease. We briefly review different methodologies such as dark lumen and bright lumen techniques for abdominal MRI. In addition, recently published studies concerning the sensitivity and accuracy in detecting inflammatory bowel changes in inflammatory bowel disease using MRI are discussed.     

Isoflavones and inflammatory bowel disease

Isoflavones constitute a class of plant hormones including genistein, daidzein, glycitein, formononetin, biochanin A, and irilone, and the major source of human intake is soybeans. Inflammatory bowel disease (IBD) is a chronic recurrent inflammatory disease including ulcerative colitis, Crohn’s disease, and indeterminate colitis, which seriously affects the quality of life of patients and has become a global health problem. Although the pathogenesis of IBD is not very clear, many factors are thought to be related to the occurrence and development of IBD such as genes, immunity, and intestinal flora. How to control IBD effectively for a long time is still a problem for gastroenterologists. Diet has an important effect on IBD. Patients with IBD should pay more attention to diet. To date, many studies have reported that isoflavones have both good and bad effects on IBD. Isoflavones have many activities such as regulating the inflammatory signal pathways and affecting intestinal barrier functions and gut flora. They can also act through estrogen receptors, as they have a similar structure to estrogen. Isoflavones are easy to get from diet for human. Whether they are valuable to be applied to the treatment of IBD is worth studying. This review summarizes the relationship between isoflavones and IBD.     

Chemiluminescence in inflammatory bowel disease patients: a parameter of inflammatory activity

Background: Reactive oxygen species (ROS) are produced in excess in the inflamed mucosa and peripheral blood of patients with inflammatory bowel disease. These species have emerged as a common pathway of tissue injury in a wide variety of inflammatory and other disease processes. The present study was conducted to assess ROS production and to correlate this with parameters of inflammatory activity. Methods: In 25 patients with Crohn's disease (CD), 20 patients with ulcerative colitis (UC) and 65 age- and sex-matched healthy volunteers ROS production was measured using the whole blood luminol enhanced chemiluminescence assay (LECA). Disease activity was assessed using the Crohn's disease activity index and the Ulcerative Colitis Symptoms Score (UCSS) for CD and UC, respectively. Furthermore, the effect of various scavengers, enzymes and enzyme inhibitors on LECA was studied to assess the contribution of different ROS. Results: LECA was significantly higher in CD and UC patients compared with healthy controls (7.1±4.7 and 9.8±6 vs. 5.2±2.8×10³ counts per minute (cpm), p<0.05 and <0.001). In CD, relative LECA (patient/control) was correlated with the Crohn's disease activity index and C-reactive protein (CRP) (r=0.54, p=0.001 and r=0.51, p=0.01). In UC, CRP but not LECA was correlated with the Ulcerative Colitis Symptoms Score (C-reactive protein: r=0.42, p=0.01). Addition of azide, superoxide dismutase, deferoxamine and dimethylthiourea resulted in a decrease of LECA values. Conclusion: Whole blood LECA is increased in patients with CD and UC. This parameter is correlated with disease activity in CD. The observed chemiluminescence is probably due to generation of superoxide and the hydroxyl radical.     

炎症性肠病患者脊柱关节炎的表现特点

目的 探讨炎症性肠病(IBD)患者的肠外表现—脊柱关节炎的发生情况,为后续炎症性肠病患者的诊断治疗提供借鉴.方法 分析2016年9月至2020年9月本院收治的210例炎症性肠病患者(其中溃疡性结肠炎/UC组138人,克罗恩病/CD组72人)肠道病变分布情况,并分析UC组及CD组患者脊柱关节炎各种分型的发生率及两组之间表...