Medicina Nuclear, Hospital Universitario Reina Sofía. Córdoba, ESPAÑA.
Unidad de Gestión Clínica Aparato Digestivo. , Hospital Universitario Reina Sofía. Córdoba, España.
Rev Esp Enferm Dig. 2019 Jan;111(1):40-45. doi: 10.17235/reed.2018.5376/2017.
Crohn's disease (CD) is a form of inflammatory bowel disease and is mainly characterized by diarrhea and abdominal pain. The aim of our study was to analyze the usefulness of performing a 75SeHCAT scan in CD patients with chronic diarrhea and suspected bile acid malabsorption (BAM). In addition, we aimed to determine whether there was a relationship with the clinical features of the disease and a previous bowel resection.
this was an observational cross-sectional study of 39 patients with a diagnosis of CD and chronic diarrhea. All cases underwent a 75SeHCAT scan for BAM diagnosis, after discarding disease activity.
the study cohort included 19 females and 20 males. The median age was 44 years and the majority of patients were A2 L1 B1 according to the Montreal classification; 84.6% of patients had undergone a previous bowel resection. BAM was present in 97.4% of patients (100% and 83.3% of patients with and without previous surgery, respectively), which was severe in 92.1% of cases. Treatment with bile acid sequestrants was initiated and a favorable response was obtained in 72.2% of patients. The relationship between BAM degree (moderate or severe), bowel surgery and the response to bile acid sequestrant treatment was also analyzed but not statistically significant.
BAM is a frequent cause of diarrhea in CD patients in endoscopic or radiological remission. This condition was present in all patients with a history of a bowel resection. A response to bile acid sequestrants treatment was observed in 73% of patients.
克罗恩病（CD）是一种炎症性肠病，主要表现为腹泻和腹痛。我们的研究目的是分析对慢性腹泻和疑似胆汁酸吸收不良（BAM）的 CD 患者进行 75SeHCAT 扫描的有用性。此外，我们还旨在确定其与疾病的临床特征和先前的肠切除术之间是否存在关系。
这是一项对 39 例 CD 合并慢性腹泻的患者进行的观察性横断面研究。所有患者均进行 75SeHCAT 扫描以诊断 BAM，在排除疾病活动后进行。
研究队列包括 19 名女性和 20 名男性。中位年龄为 44 岁，大多数患者根据蒙特利尔分类为 A2 L1 B1；84.6%的患者有过先前的肠切除术。97.4%的患者存在 BAM（分别为 100%和 83.3%的有和无既往手术患者），其中 92.1%的患者为重度。开始使用胆汁酸螯合剂治疗，72.2%的患者获得了良好的反应。还分析了 BAM 程度（中度或重度）、肠手术与胆汁酸螯合剂治疗反应之间的关系，但无统计学意义。
BAM 是内镜或影像学缓解的 CD 患者腹泻的常见原因。这种情况在所有有肠切除术史的患者中均存在。胆汁酸螯合剂治疗的反应率为 73%。
