Xavier Sofia, Cúrdia Gonçalves Tiago, Dias de Castro Francisca, Magalhães Joana, Rosa Bruno, Moreira Maria João, Cotter José
a Gastroenterology Department , Hospital Senhora da Oliveira , Guimarães , Portugal.
b Life and Health Sciences Research Institute (ICVS), School of Medicine , University of Minho , Braga , Portugal.
Scand J Gastroenterol. 2018 Apr;53(4):426-429. doi: 10.1080/00365521.2018.1437928. Epub 2018 Feb 15.
Perianal Crohn's disease (CD) prevalence varies according to the disease location, being particularly frequent in patients with colonic involvement. We aimed to evaluate small bowel involvement and compare small bowel capsule endoscopy findings and inflammatory activity between patients with and without perianal disease.
Retrospective single-center study including 71 patients - all patients with perianal CD (17 patients) who performed a small bowel capsule endoscopy were included, and non-perianal CD patients were randomly selected (54 patients). Clinical and analytical variables at diagnosis were reviewed. Statistical analysis was performed with SPSS v21.0 and a two-tailed p value <.05 was defined as indicating statistical significance.
Patients had a median age of 30 ± 16 years with 52.1% females. Perianal disease was present in 23.9%. Patients with perianal disease had significantly more relevant findings (94.1% vs 66.6%, p = .03) and erosions (70.6% vs 42.6%, p = .04), however, no differences were found between the two groups regarding ulcer, villous edema and stenosis detection. Overall, patients with perianal disease had more frequently significant small bowel inflammatory activity, defined as a Lewis Score ≥135 (94.1% vs 64.8%, p = .03), and higher Lewis scores in the first and second tertiles (450 ± 1129 vs 0 ± 169, p = .02 and 675 ± 1941 vs 0 ± 478, p = .04, respectively). No differences were found between the two groups regarding third tertile inflammatory activity assessed with the Lewis Score.
Patients with perianal CD have significantly higher inflammatory activity in the small bowel, particularly in proximal small bowel segments, when compared with patients without perianal disease.
肛周克罗恩病（CD）的患病率因疾病部位而异，在结肠受累患者中尤为常见。我们旨在评估小肠受累情况，并比较有无肛周疾病患者的小肠胶囊内镜检查结果及炎症活动度。
一项回顾性单中心研究，纳入71例患者——所有进行小肠胶囊内镜检查的肛周CD患者（17例）均被纳入，非肛周CD患者为随机选取（54例）。回顾诊断时的临床和分析变量。使用SPSS v21.0进行统计分析，双侧p值<.05被定义为具有统计学意义。
患者的中位年龄为30±16岁，女性占52.1%。肛周疾病的发生率为23.9%。有肛周疾病的患者有显著更多的相关发现（94.1%对66.6%，p = .03）和糜烂（70.6%对42.6%，p = .04），然而，两组在溃疡、绒毛水肿和狭窄检测方面未发现差异。总体而言，有肛周疾病的患者更常出现显著的小肠炎症活动，定义为Lewis评分≥135（94.1%对64.8%，p = .03），且在第一和第二三分位数中Lewis评分更高（分别为450±1129对0±169，p = .02和675±1941对0±478，p = .04）。两组在使用Lewis评分评估的第三三分位数炎症活动度方面未发现差异。
与无肛周疾病的患者相比，肛周CD患者小肠的炎症活动度显著更高，尤其是在近端小肠段。
