经肠系膜上动脉血流多普勒超声评估克罗恩病的活动度。

Assessment of activity of Crohn's disease by Doppler sonography of superior mesenteric artery flow.

机构信息

Department of Gastroenterology A, La Rabta Hospital, 1007 Tunis, Tunisia.

出版信息

J Crohns Colitis. 2010 Sep;4(3):334-40. doi: 10.1016/j.crohns.2009.12.011. Epub 2010 Jan 25.

DOI:10.1016/j.crohns.2009.12.011

PMID:21122523

Abstract

BACKGROUND

Evaluation of activity of Crohn's disease is based on CDAI. Several other tools have been studied to assess disease activity with more accuracy.

AIMS

To assess the correlation between Doppler parameters of superior mesenteric artery and disease activity and to assess the accuracy of these parameters in discriminating between active and quiescent Crohn's disease.

MATERIAL AND METHODS

We perform a prospective study including non-operated and non-complicated Crohn's disease patients involving terminal ileum and/or right colon and sex and age-matched controls. Doppler sonography of superior mesenteric artery was performed in all subjects.

RESULTS

We studied 41 patients and 15 controls. There was no statistical difference between patients and controls according to the studied US parameters. The difference in resistance index between the three groups using analysis of variance is not significant (p=0.064). Resistance index was significantly lower in patients with active disease compared to inactive disease patients (0.82 +/- 0.04 vs 0.85 +/- 0.03; p=0.01). Pulsatility index was also lower in patients with active disease compared to inactive disease patients (1.37 +/- 0.21 vs 1.53 +/- 0.15; p=0.01). A value of resistance index less than 0.79 predicted active disease with a sensitivity of 35.3% and specificity of 95.7%. A value of pulsatility index less than 1.56 predicted active disease with a sensitivity of 94.1% and specificity of 43.5%. In case of resistance index less than 0.79 and pulsatility index less than 1.56 in the same patient, the probability of active disease was 86%. However, in case of resistance index over than 0.79 and pulsatility index over than 1.56, this probability was only 9%. In Crohn's disease patients, correlation study showed that resistance index value was significantly correlated with CDAI (r=-0.46; p=0.003). Pulsatility index value was also correlated with CDAI (r=-0.39; p=0.01).

CONCLUSION

Doppler sonographic parameters of superior mesenteric artery are significantly correlated with disease activity in non-operated and non-complicated Crohn's disease.

摘要

背景

克罗恩病的活动评估基于 CDAI。已经研究了其他几种工具来更准确地评估疾病活动。

目的

评估肠系膜上动脉多普勒参数与疾病活动的相关性，并评估这些参数在鉴别活动期和缓解期克罗恩病中的准确性。

材料和方法

我们进行了一项前瞻性研究，纳入了非手术和非复杂的克罗恩病患者，涉及末端回肠和/或右结肠，并与性别和年龄匹配的对照组进行比较。所有受试者均行肠系膜上动脉多普勒超声检查。

结果

我们研究了 41 名患者和 15 名对照者。根据研究的 US 参数，患者与对照组之间无统计学差异。方差分析显示，三组之间的阻力指数差异无统计学意义（p=0.064）。与缓解期患者相比，活动期患者的阻力指数明显降低（0.82±0.04 与 0.85±0.03；p=0.01）。与缓解期患者相比，活动期患者的搏动指数也较低（1.37±0.21 与 1.53±0.15；p=0.01）。阻力指数小于 0.79 预测活动期疾病的灵敏度为 35.3%，特异性为 95.7%。搏动指数小于 1.56 预测活动期疾病的灵敏度为 94.1%，特异性为 43.5%。如果同一患者的阻力指数小于 0.79 且搏动指数小于 1.56，则活动期疾病的可能性为 86%。然而，如果阻力指数大于 0.79 且搏动指数大于 1.56，则该可能性仅为 9%。在克罗恩病患者中，相关性研究表明阻力指数值与 CDAI 显著相关（r=-0.46；p=0.003）。搏动指数值也与 CDAI 相关（r=-0.39；p=0.01）。