溃疡性结肠炎内镜、病理特点及其临床意义

目的探讨溃疡性结肠炎内镜及病理组织学检查的临床特点及其意义。方法采用分级的方法描述219例活动期溃疡性结肠炎以及53例治疗后临床症状完全缓解者的内镜、病理组织学特点。运用Spearman等级相关系数进行相关分析。结果本组219例活动期溃疡性结肠炎内镜分级主要分布在Ⅱ～Ⅲ级，占59．8％。病理组织学分级主要分布在Ⅲ～Ⅳ级，占79．9％（r=0．1692，P=0．0122）。经治疗后4周～8个月间，53例临床症状完全消失。内镜分级由治疗前的Ⅲ～Ⅳ级向Ⅰ～Ⅱ级转归，而病理组织学分级Ⅳ级为22．7％（r=0．3007，P=0．0287）。内镜分级与病理组织学分级两者间均无相关性。结论本组内镜及病理组织学分级描述溃疡性结肠炎病情以及疗效有不一致性。早期诊断以及近期疗效的判断不仅应依靠临床症状及内镜检查所见，更应结合病理组织学检查。

The characters and clinical significance of biopsy and endoscopy in patients with ulcervative colitis

Objective To investigate the correlation between the grades of mucosal biopsy and endoscopy in patients with active ulcerative colitis.Methods 219 cases of ulcerative colitis and 53 treated cases were evaluated by grading pathology and endoscopy.The results were processed to calculate the Spearman correlation coefficients.Results The correlation between endoscopy grade and biopsy degree was(r=0.1692,P=0.0122) in the 219 cases of acute ulcerative colitis;and was(r=(0.3636,) P=0.0075) and(r=0.3007,P=0.0287) before and after the treatment respectively,in the 53 patients with clinical remission.Conclusion There is no correlation between clinical endoscopic and pathologic grades in active ulcerative colitis.The diagnosis and evaluation of therapy should be based on a comprehensive consideration of the endoscopic and pathologic findings and clinical manifestations.