摘要
目的:分析肠结核(ITB)与克罗恩病(CD)临床及内镜特点,指导临床鉴别。方法:收集医院消化内科确诊的ITB或CD病例进行回顾性分析。结果:ITB组患者41例,CD组患者90例。CD组多为男性(男:女为68:22),肛周病变(72.22%)、大便隐血阳性(57.78%)发生率明显高于ITB组(分别为7.32%、39.02%),ITB组盗汗,合并其他部位结核、肠梗阻,CA125升高、PPD及T-SPOT.TB阳性发生率分别为9.76%、51.22%、21.95%、31.71%、65.85%、90.24%,多于CD组(分别为0%、5.56%,6.67%、13.33%、5.56%、15.56%),差异均有统计学意义(P<0.05);在内镜下,ITB组病变多为环形溃疡,位于回盲部,CD组病变多为纵行溃疡、节段性、鹅卵石样改变,累及回肠末端、降结肠、乙状结肠及直肠(P<0.05);两者均可有非干酪样肉芽肿,干酪样肉芽肿仅见于ITB(P=0.046)。结论:ITB与CD临床表现相似,难以鉴别,需综合临床、实验室、内镜及病理多方面区分。
Objective:To analyze the clinical and endoscopic characteristics of intestinal tuberculosis (ITB) and Crohn’s disease (CD) in order to guide the clinical differentiation.Methods:the cases of CD or ITB diagnosed in our hospital were analyzed retrospectively.Results:There were 41 patients with ITB,and 90 patients with CD.The CD group was dominated by men(male:female was 68:22).In CD group,the incidence of perianal disease(72.22%) and fecal OB positive(57.78%) was significantly higher than that in ITB group (7.32%,39.02%),but night sweats (9.76%),tuberculosis(51.22%),intestinal obstruction (21.95%),abnormal CA125(31.71%),PPD positive (65.85%) and TSPOT.TB positive(90.24%) were more frequent in ITB than in CD group (0%,5.56%,6.67%,13.33%,5.56%,15.56%).Under endoscopy,the lesions in ITB group mostly involved the ileocecal part,which was transverse ulcer,and the lesions in CD group mostly involved the terminal ileum,descending colon,sigmoid colon and rectum,which were longitudinal ulcers,cobblestone changes,and segmental changes (P<0.05).Both may have noncheesy granulomas,but caseous granulomas were seen only in ITB(P=0.046).Conclusion:Its difficult to distinguish ITB from CD clinically,and we should compare in clinical,laboratory,endoscopic and pathological aspects.
作者
胡芹芹
丁西平
陈晓婉
HU Qin-qin;DING Xi-ping;CHEN Xiao-wan(Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei 230001,Anhui)
出处
《安徽卫生职业技术学院学报》
2021年第2期38-40,共3页
Journal of Anhui Health Vocational & Technical College
关键词
肠结核
克罗恩病
诊断
鉴别
intestinal tuberculosis
crohn disease
diagnosis
differential
作者简介
通信作者:丁西平,男,主任医师。
