Lorenz-Meyer H, Malchow H, Miller B, Stock H, Brandes J W
Digestion. 1985;31(2-3):109-19. doi: 10.1159/000199187.
130 patients with Crohn's disease were colonoscopied in a multicenter trial. The obtained data were analyzed with respect to gathering information on the inflammation pattern, as well as on the importance and prognostic value of special lesions in Crohn's colitis. In 52 patients a second endoscopy was performed at the end of the 2-year study period. Ulcerations and aphthous lesions were the most common lesions, followed by pseudopolyps, cobblestone lesions and stenosis. In general, there was an increasing, distal gradient in the frequency of severe lesions. patients with Crohn's colitis alone had more signs of inflammation than patients with additional involvement of the small intestine. A segmental pattern was the most common form of inflammation. The group of patients (14%) with a continuous pattern did not deviate from the whole collective in clinical activity. In patients with previous resections, inflammation near the anastomosis was accompanied more often than not by stenosis. Patients with ulcerations had a rather short time since confirmation of the diagnosis. Cobblestone lesions and pseudopolyps correlated with short symptomatology. During the follow-up of the study, patients taking steroids or a combination with prednisolone and sulfasalazine seem to have better results than those under placebo or sulfasalazine alone, as regards the more severe symptoms.
在一项多中心试验中,对130例克罗恩病患者进行了结肠镜检查。分析所获数据,以收集有关炎症模式的信息,以及克罗恩结肠炎特殊病变的重要性和预后价值。在52例患者中,在为期2年的研究结束时进行了第二次内镜检查。溃疡和阿弗他病变是最常见的病变,其次是假息肉、鹅卵石样病变和狭窄。一般来说,严重病变的发生率呈远端递增趋势。仅患有克罗恩结肠炎的患者比小肠也受累的患者有更多的炎症迹象。节段性模式是最常见的炎症形式。呈连续性模式的患者组(14%)在临床活动方面与整个群体并无差异。在既往有手术切除史的患者中,吻合口附近的炎症往往伴有狭窄。有溃疡的患者自确诊以来病程较短。鹅卵石样病变和假息肉与症状持续时间短相关。在研究随访期间,就较严重症状而言,服用类固醇或泼尼松龙与柳氮磺胺吡啶联合用药的患者似乎比单独使用安慰剂或柳氮磺胺吡啶的患者效果更好。