双气囊内镜与多层螺旋CT小肠造影在小肠克罗恩病诊断中的作用

目的 研究双气囊内镜(DBE)和多层螺旋CT小肠造影(MSCTE)在小肠克罗恩病(CD)诊断中的价值.方法 对71例临床疑似小肠CD患者分别进行DBE和MSCTE检查并作出诊断.结合病理及临床随访结果,比较两种方法在小肠CD诊断、判断病变范围、活动性和并发症等方面的能力.结果 DBE与MSCTE对小肠CD确诊率相似,两者间差异无统计学意义(χ2=2.29,P>0.05).前者阳性似然比为22.5,阴性似然比为0.022;后者阳性似然比为1.6,阴性似然比为0.240.两种检查方法对于无-轻度管腔狭窄者判断的一致性明显高于中-重度管腔狭窄者(χ2=11.298,P=0.001).DBE与MSCTE对疾病活动性判断的一致性为95.8%.结论 DBE可能是确诊小肠CD的首选方法,与MSCTE联合应用有利于诊断和评价小肠CD患者的病情.     

英夫利昔在克罗恩病维持缓解中的应用

克罗恩病(Crohn disease,CD)是一种由于环境、感染、遗传因素等诸多因素综合作用后导致的免疫功能紊乱,最终表现为反复发作的肠道炎症、溃疡和(或)全身症状。英夫利     

双气囊内镜在小肠克罗恩病疗效随访中的应用价值初探

目的探讨双气囊内镜（DBE）在小肠克罗恩病（CD）疗效随访中的应用和价值。方法对41例曾行DBE检查并临床确诊为小肠CD的患者进行正规药物治疗并随访，评估临床症状、血清学指标、治疗时间与DBE下黏膜修复情况之间的关系。结果治疗1个月后92．7％的患者症状缓解，2个月后97．6％C-反应蛋白恢复正常。行DBE复查黏膜无明显改善或略有改善、改善、明显改善者，平均复查时间为治疗后（7．1±4．3）、（16．5±7．1）、（25．0±12．7）个月，3组间复查时间差异有统计学意义（P〈0．01）。对于累及小肠-结肠的患者，同一个体的小肠、结肠黏膜修复程度差异无统计学意义（P=0．215）。结论小肠CD黏膜修复缓慢，明显迟于临床症状的缓解及C反应蛋白的恢复，合理的DBE复查时间为治疗后10～15个月，免疫抑制剂宜长期维持。对于同时累及小肠-结肠的患者，可行结肠镜复查。     

双气囊内镜与多层螺旋CT小肠造影在小肠克罗恩病诊断中的作用

Objective To investigate the value of double-balloon endoscopy (DBE) and multi-slice CT enteroclysis (MSCTE) in diagnosis of Crohn's disease (CD) in small intestine. Methods DBE and MSCTE were performed in 71 patients with suspected Crohn's disease in small intestine. The two methods were compared in terms of diagnosis, extents of disease, existance of complications and activity of the disease according to the pathologic findings and the outcome of follow-up. Results The diagnostic yields of DBE and MSCTE were comparable with no significant difference (χ2=2.29, P> 0.05). The positive and negative likelihood ratios were 22.5 and 0. 022 in DBE respectively, and were 1.6 and 0. 240 in MSCTE respectively. The results of DBE was consistent with MSCTE in diagnosis of mild bowel stenosis, but was inconsistent with MSCTE in diagnosis of moderate-severe bowel stenosis (χ2=11.298, P=0.001). The concordance of two methods in diagnosis of disease activity was 95.8%. Conclusions The first choice in diagnosis of small bowel CD is DBE. The combination of two methods will be helpful in diagnosis and evaluation of CD severity.