幽门螺杆菌感染与炎症性肠病相关性研究

目的探讨幽门螺杆菌感染与炎症性肠病的相关性。方法选取炎症性肠病患者52例作为炎症组,其中溃疡性结肠炎患者30例(溃疡性结肠炎组,包括全结肠受累18例与部分结肠受累12例)、Crohn病患者22例(Crohn病组);有消化道症状但肠镜检查正常者60例作为正常组。应用~(14)C尿素呼气试验检测炎症组与正常组幽门螺杆菌感染率。结果炎症组幽门螺杆菌感染率为19.2%(10/52),正常组为46.7%(28/60),炎症组明显低于正常组,差异有统计学意义(P<0.05)。溃疡性结肠炎组幽门螺杆菌感染率为20.0%(6/30),Crohn病组为18.2%(4/22),两组间比较,差异无统计学意义(P>0.05)。溃疡性结肠炎组中,全结肠受累患者幽门螺杆菌感染率为5.6%(1/18),部分结肠受累患者为41.7%(5/12),全结肠受累明显低于部分结肠受累,差异有统计学意义(P<0.05)。结论幽门螺杆菌感染可能预防炎症性肠病的发生与进展。     

核素炎症定位显像在炎症性肠道疾病中的临床应用

核素炎症定位显像有助于早期诊断溃疡性结肠炎与 Crohn’s病 ,特别是能够判断疾病的活动度 ,评价其对治疗的反应。本文简单介绍几种用于这二种疾病诊断的放射性药物及各自临床应用价值     

细菌与炎症性肠病

炎症性肠病（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（UC）和克罗恩病（CD）。此病可能的病因有由基因决定的宿主易患性、肠道细菌的作用、自身免疫、环境因素等。肠道细菌的感染因素作为一种主要病因,虽尚未被证实,但已有许多研究表明,细菌是IBD的促发因素。近年的研究表明,     

细胞因子与炎症性肠病

炎症性肠病目前认为是由多因素相互作用所致,主要包括免疫、环境以及遗传等因素,而由活化的免疫细胞产生的细胞因子,在IBD发病机制中起的作用,越来越引起人们关注。本文对常见的促炎细胞因子、抗炎细胞因子及具有免疫调节活性的细胞因子进行综述。     

核素炎症定位显像在炎症性肠道疾病中的临床应用

核素炎症定位显像有助于早期诊断溃疡性结肠炎与Crohn's病，特别是能够判断疾病的活动度，评价其对治疗的反应。本简单介绍几种用迂二种疾病诊断的放射性药物及各自临床应用价值。     

53例初诊儿童炎症性肠病临床分析

目的探讨儿童炎症性肠病(IBD)初诊临床特点,提高对儿童IBD的认识。方法回顾性分析2005年1月至2015年10月于中国医科大学附属盛京医院儿科初诊,并确诊为IBD的53例患儿的临床资料,包括临床表现、实验室检查、影像学、内窥镜和病理组织学结果,以及治疗方案。结果 IBD患儿的临床表现主要以腹痛、腹泻、便血、发热为主。其中,溃疡性结肠炎(UC)患儿较克罗恩病(CD)患儿更易出现腹泻及便血症状(P<0.05),而CD患儿腹痛症状更为明显(P<0.05),同时更易出现肠外表现,34.0%患儿出现生长发育和营养障碍,84.9%患儿存在不同程度的精神状态改变。实验室检查结果以炎症性指标(如白细胞、C-反应蛋白、血沉)升高为主,UC和CD患儿的血清白蛋白比较,差异有统计学意义(P<0.05)。UC和CD患儿,内镜及病理表现明显不同,MRE同时观察到肠壁强化和瘘管及肿块的形成。51例单纯药物治疗,2例联合手术治疗。其中,13例患儿应用了英夫利昔单抗(IFX)治疗,诱导缓解迅速,身高、体质量有所增长。结论对临床出现腹痛、腹泻、便血、发热以及营养状态不佳的患儿,要警惕IBD的发生;需结合生化、影像学、内镜、病理进行综合诊断;MRE无创、无辐射,值得推广;中重度患者,IFX可以迅速缓解病情,促进生长发育。     

炎症性肠病临床、病理及影像学诊断研究进展

随着生活节奏加快、环境因素影响和饮食结构的变化,我国炎症性肠病的发病率近年呈持续上升趋势.临床医生对该病的诊断主要依靠内镜病理,但其敏感性、特异性和病人顺应性不高.随着影像技术的快速发展,多种无创伤性的影像诊断方法 正在成为炎症性肠病筛查和诊断的重要手段,对内镜和病理诊断起到了协同、补充的作用.     

炎症性肠病的MRI进展

炎症性肠病（IBD）是一组病因不明的慢性炎症性肠病,包括克罗恩病（CD）和溃疡性结肠炎（UC）,常导致肠腔狭窄或穿透性肠损伤,其病程发展过程中需要经常评估疾病的活动性和并发症,以便制定正确的治疗方案。MRI软组织分辨力高,可以获得肠壁的动态信息,已应用于对IBD的检出、评估病变活动性、判断病变纤维化程度及鉴别CD与UC等。就MR小肠成像、扩散加权成像、动态增强MRI及磁化传递成像等在IBD中的应用进展予以综述。     

蛋白组织学研究在炎症性肠病中的应用

炎症性肠病（inflammatory bowel disease,IBD）是一组病因未明的慢性非特异性肠道炎症性疾病．目前大多数学者将其归结为自身免疫性疾病,包括溃疡性结肠炎（Ulcerative colitis,UC）和克罗恩病（Crohn’s disease．CD）。两者发病的基本病理过程相似,但其发病部位及临床表现不全相同,前者常自远端结肠开始发病,逆行向近端发展。严重时甚至累及全结肠及末端回肠,主要累及肠黏膜及黏膜下层,属于慢性非特异性结肠炎;后者可累及胃肠道各部位,但以末端回肠及其邻近结肠受累最为常见,     

MRI in patients with inflammatory bowel disease

Inflammatory bowel disease (IBD) affects ≈1.4 million people in North America and, because of its typical early age of onset and episodic disease course, IBD patients often undergo numerous imaging studies over the course of their lifetimes. Computed tomography (CT) has become the standard imaging modality for assessment of IBD patients because of its widespread availability, rapid image acquisition, and ability to evaluate intraluminal and extraluminal disease. However, repetitive CT imaging has been associated with a significant ionizing radiation risk to patients, making MRI an appealing alternative IBD imaging modality. Pelvic MRI is currently the imaging gold standard for detecting perianal disease, while recent studies indicate that MRI bowel-directed techniques (enteroclysis, enterography, colonography) can accurately evaluate bowel inflammation in IBD. With recent technical innovations leading to faster and higher resolution body MRI, the role of MRI in IBD evaluation is likely to continue to expand. Future applications include surveillance imaging, detection of mural fibrosis, and early assessment of therapy response.     

Advanced multimodality imaging of inflammatory bowel disease in 2015: An update

The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic. In this review, we will describe, with illustrative images, the imaging features of IBD in adults, with emphasis on up-to-date imaging techniques focusing predominantly on cross sectional imaging and new magnetic resonance imaging techniques.     

Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

The case of a 14-year-old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.     

Crohn病及溃疡性结肠炎的~(99)Tc~m-HIgG定位显像

目的　了解Crohn病和溃疡性结肠炎99Tcm HIgG炎症定位显像的图像特点 ,评估其对确定炎症病变部位、范围及活动程度的价值。方法　对照组 11例 ,男 7例 ,女 4例 ,平均年龄 (38± 10 )岁。确诊的溃疡性结肠炎患者 2 2例 ,Crohn病患者 19例 ,男 2 8例 ,女 13例 ,平均年龄 (35± 15 )岁。静脉注射99Tcm HIgG 370～ 740MBq(1mg)后 ,分别于 1,2 ,4,6h显像 ,必要时加做 2 4h显像 ,采用前后位及后前位全身显像 ,必要时加做局部平面及断层显像。结果　 2 2例溃疡性结肠炎患者中 2 1例显像阳性 ,1例阴性 ,阳性率为 95 %。 19例Crohn病患者 17例阳性 ,2例阴性 ,阳性率为 89%。对照组均为阴性。上述阳性患者均在炎症性肠道疾病活动期 ,而阴性者均为缓解期。结论　99Tcm HIgG显像安全 ,简便 ,无副作用 ,对活动期炎症性肠道疾病诊断灵敏度高 ,有助于疾病的随访和疗效的评估     

The impact of helical computed tomography on the diagnosis of unsuspected inflammatory bowel disease in the large bowel

Inflammatory bowel diseases (IBD) are diagnoses that can be easily overlooked clinically. The aim of this study was to investigate if CT is able to make a contribution to the identification of previously unsuspected cases of IBD. We retrospectively identified cases in which the possibility of an IBD was raised in CT reports (over a 4-year period), by utilising a keyword search of the radiology database. Cases with a previously known or suspected IBD were rigorously excluded by review of case notes, and endoscopic, radiological, histological and microbiological findings. The CT images of the identified cases were reviewed by a blinded observer to document the extent of bowel wall thickening, the location of lesion(s), and presence of peri-colic fat abnormality, ascites and/or collections. The observer also attempted to corroborate the presence, and to identify the type, of IBD based on the CT appearances alone. Thirty-five cases (out of approximately 19,000 body CTs performed) of clinically unsuspected IBD were identified, of which 27 underwent further investigation. An IBD was confirmed in 48% (13 of 27): Crohn's disease (n=6), ulcerative colitis (n=2), pseudomembranous colitis (n=3) and other (n=2), of which 70% (9 of 13) were correctly typed by the reviewer. Inflammatory bowel disease was not substantiated in the remainder (14 of 27), although 7 of these had other bowel pathologies: diverticular disease (n=4); and carcinoma (n=3). Prospectively determining the presence, and furthermore type, of IBD on CT is challenging largely because of the considerable overlap in the appearances of the individual IBDs and indeed of normality. Nevertheless, CT is able to identify clinically unsuspected cases and radiologists should be alert to this treatable and not infrequently elusive diagnosis. Electronic Publication