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比较溃疡性结肠炎和克罗恩病的胶囊内镜下小肠病变:单中心回顾性分析。

Comparison of Small Bowel Lesions Using Capsule Endoscopy in Ulcerative Colitis and Crohn's Disease: A Single-Center Retrospective Analysis.

机构信息

Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.

Department of Endoscopy, Fukuoka University Chikushi Hospital, Fukuoka, Japan.

出版信息

Digestion. 2018;98(2):119-126. doi: 10.1159/000487796. Epub 2018 Apr 26.

Abstract

BACKGROUND

Capsule endoscopy (CE) has allowed the characterization of small bowel lesions. However, small bowel lesions in ulcerative colitis (UC) have not been elucidated and no studies have compared between UC and Crohn's disease (CD).

AIM

The objective of this study was to investigate the small bowel lesions in UC, and to characterize UC lesions by comparison with CD.

METHODS

Subjects comprised 54 UC patients and 39 CD patients who underwent CE. We retrospectively investigated characteristics of small bowel lesions in UC. We also compared endoscopic findings and degree of inflammation between UC and CD.

RESULTS

The incidence of small bowel lesions in UC was 27.8%. The group with small bowel lesions exhibited higher endoscopic activity in the colon than without small bowel lesions (p = 0.002). Comparing small bowel lesions between UC and CD, significantly more ulcerative lesions, notched appearance, longitudinal tendency of lesions, and cobblestone appearance were seen in CD. The Lewis score was significantly higher in CD than UC in the second and third tertiles (205 ± 379 vs. 73 ± 223, p = 0.01; 358 ± 449 vs. 105 ± 333, p < 0.001).

CONCLUSIONS

Small bowel lesions in UC were linked to colonic activity. UC and CD differ in terms of the morphology and distribution of small bowel lesions.

摘要

背景

胶囊内镜(CE)能够对小肠病变进行特征描述。然而,溃疡性结肠炎(UC)的小肠病变尚未阐明,也没有研究比较 UC 和克罗恩病(CD)之间的差异。

目的

本研究旨在探讨 UC 的小肠病变,并通过与 CD 进行比较来对 UC 病变进行特征描述。

方法

纳入 54 例 UC 患者和 39 例 CD 患者进行 CE。我们回顾性调查了 UC 患者小肠病变的特征。我们还比较了 UC 和 CD 之间内镜表现和炎症程度。

结果

UC 患者的小肠病变发生率为 27.8%。有小肠病变的组结肠内镜活动度高于无小肠病变的组(p=0.002)。比较 UC 和 CD 之间的小肠病变,CD 中更常见溃疡性病变、切迹样外观、病变的纵向趋势和鹅卵石样外观。在第二和第三三分位,CD 的 Lewis 评分显著高于 UC(205±379 比 73±223,p=0.01;358±449 比 105±333,p<0.001)。

结论

UC 的小肠病变与结肠活动度相关。UC 和 CD 在小肠病变的形态和分布方面存在差异。

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