Jin Rui-Fang, Chen Yi-Man, Chen Ren-Pin, Ye Hua-Jun
Department of Gastroenterology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, Zhejiang Province, China.
World J Clin Cases. 2022 May 26;10(15):4818-4826. doi: 10.12998/wjcc.v10.i15.4818.
Ulcerative colitis (UC) is usually diagnosed through histopathology, enteroscopy, clinical symptoms, and physical findings; however, it is difficult to accurately evaluate disease severity.
To investigate the value of endoscopic ultrasonography (EUS) in the evaluation of the severity and prognosis of UC.
Patients with UC who were seen in our hospital from March 2019 to December 2020 were eligible, and disease severity was evaluated according to the modified Truelove and Witts and Mayo scores. We performed EUS, calculated the UC endoscopic index of severity (UCEIS) and EUS-UC scores, and administered appropriate treatment. The UCEIS and EUS-UC scores of patients were assessed in relation to disease severity, and the correlations between UCEIS and EUS-UC scores and disease severity was also analyzed. The UCEIS and EUS-UC scores before and after treatment were also compared.
A total of 79 patients were included in this study. According to the Mayo Index, 23, 32, and 24 patients had mild, moderate and severe UC, respectively. The UCEIS and EUS-UC scores were higher in moderate cases (4.98 ± 1.04 and 5.01 ± 0.99, respectively) than in mild cases (1.56 ± 0.82 and 1.64 ± 0.91, respectively, < 0.05). Furthermore, the UCEIS and EUS-UC scores (7.31 ± 1.10 and 7.59 ± 1.02, respectively) were higher in severe cases than in moderate cases ( < 0.05). According to the modified Truelove and Witts scores, 21, 36, and 22 patients were classified as having mild, moderate and severe disease, respectively. The UCEIS and EUS-UC scores were significantly higher in moderate disease (4.79 ± 1.11 and 4.96 ± 1.23, respectively) than in mild disease (1.71 ± 0.78 and 1.69 ± 0.88, respectively, < 0.05). Additionally, the UCEIS and EUS-UC scores in severe disease (7.68 ± 1.22 and 7.81 ± 0.90, respectively) were significantly higher than in moderate disease ( < 0.05). The UCEIS and EUS-UC scores were significantly and positively correlated with disease severity according to the modified Truelove and Witts score and Mayo score ( < 0.05). The UCEIS and EUS-UC scores after 2 mo of treatment (3.88 ± 0.95 and 4.01 ± 1.14, respectively) and after 6 mo of treatment (1.59 ± 0.63 and 1.64 ± 0.59, respectively) were lower than the respective scores before treatment (5.93 ± 1.79 and 6.04 ± 2.01) ( < 0.05).
EUS can clarify the status of UC and accurately evaluate the treatment response, providing an objective basis for formulation and adjustment of the treatment plan.
溃疡性结肠炎（UC）通常通过组织病理学、肠镜检查、临床症状和体格检查来诊断；然而，准确评估疾病严重程度较为困难。
探讨内镜超声（EUS）在评估UC严重程度及预后中的价值。
选取2019年3月至2020年12月在我院就诊的UC患者，根据改良的Truelove和Witts评分及Mayo评分评估疾病严重程度。进行EUS检查，计算UC内镜严重程度指数（UCEIS）和EUS-UC评分，并给予适当治疗。评估患者的UCEIS和EUS-UC评分与疾病严重程度的关系，分析UCEIS和EUS-UC评分与疾病严重程度之间的相关性。同时比较治疗前后的UCEIS和EUS-UC评分。
本研究共纳入79例患者。根据Mayo指数，分别有23例、32例和24例患者患有轻度、中度和重度UC。中度病例的UCEIS和EUS-UC评分（分别为4.98±1.04和5.01±0.99）高于轻度病例（分别为1.56±0.82和1.64±0.91，P<0.05）。此外，重度病例的UCEIS和EUS-UC评分（分别为7.31±1.10和7.59±1.02）高于中度病例（P<0.05）。根据改良的Truelove和Witts评分，分别有21例、36例和22例患者被分类为患有轻度、中度和重度疾病。中度疾病的UCEIS和EUS-UC评分（分别为4.79±1.11和4.96±1.23）显著高于轻度疾病（分别为1.71±0.78和1.69±0.88，P<0.05）。此外，重度疾病的UCEIS和EUS-UC评分（分别为7.68±1.22和7.81±0.90）显著高于中度疾病（P<0.05）。根据改良的Truelove和Witts评分及Mayo评分，UCEIS和EUS-UC评分与疾病严重程度呈显著正相关（P<0.05）。治疗2个月后（分别为3.88±0.95和4.01±1.14）及治疗6个月后（分别为1.59±0.63和1.64±0.59）的UCEIS和EUS-UC评分低于治疗前（分别为5.93±1.79和6.04±2.01）（P<0.05）。
EUS可明确UC的病情，准确评估治疗反应，为治疗方案的制定和调整提供客观依据。
