Yang Xue-song, Zhang Lei, Shi Xue-ying, Zhang Yun-li, Lv Yu-min
Department of Gastroenterology, Peking University Third Hospital, Beijing 100083, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2006 Aug 18;38(4):407-10.
To evaluate the contemporary diagnostic and therapeutic status for Crohn's disease (CD), and analyze its clinical and pathologic manifestation.
Retrospectively we reviewed 220 hospitalized inflammatory bowel disease (IBD) cases in which 48 were diagnosed as CD. Data of diagnostic and therapeutic details were recorded.
In the past 10 years 44 of the 48 CD cases were diagnosed in recent and 75.0% of the cases were in the onset age range from 17 to 40 years. The most common symptoms were abdominal pain, diarrhea and bloody stool. 16 (33.3%) of the cases were accompanied with extra-intestinal manifestations, 3 (6.3%) with perianal abscess, and 2 (4.2%) with intestinal fistulation. The main findings through colonoscopy were ulceration, obstruction and cobble stone sign, with a diagnostic correspondence of 85.7% (36/42). Non-caseous granulomas were totally identified in 43.2% (19/44) of the histology. Thirty cases were administrated with Sulfasalazine/Mesalazine (SASP/5-ASA) or corticosteroids/immuno-suppressor in which 27 got clinically improved. Thirteen patients underwent surgery.
The diagnostic incidence of Crohn's disease has been increased in recent years. The combination of endoscopy, radiography and histology is the best way for the diagnosis of CD. Small intestinal endoscopy and capsule endoscopy with repeated histopathology and follow-up are helpful for the diagnosis.
评估克罗恩病（CD）的当代诊断和治疗现状，并分析其临床和病理表现。
回顾性分析220例住院炎性肠病（IBD）患者，其中48例诊断为CD。记录诊断和治疗的详细数据。
在过去10年中，48例CD患者中有44例为近期诊断，75.0%的患者发病年龄在17至40岁之间。最常见的症状是腹痛、腹泻和便血。16例（33.3%）伴有肠外表现，3例（6.3%）伴有肛周脓肿，2例（4.2%）伴有肠瘘。结肠镜检查的主要发现为溃疡、梗阻和鹅卵石样改变，诊断符合率为85.7%（36/42）。组织学检查中43.2%（19/44）发现非干酪样肉芽肿。30例患者接受柳氮磺胺吡啶/美沙拉嗪（SASP/5-ASA）或糖皮质激素/免疫抑制剂治疗，其中27例临床症状改善。13例患者接受了手术。
近年来克罗恩病的诊断发病率有所增加。内镜检查、影像学检查和组织学检查相结合是诊断CD的最佳方法。小肠镜检查和胶囊内镜检查，重复组织病理学检查和随访有助于诊断。
