克罗恩病患者术前严重淋巴细胞减少的预后意义
Prognostic significance of severe preoperative lymphopenia in patients with Crohn's disease.
作者信息
Heimann T M, Bolnick K, Aufses A H
出版信息
Ann Surg. 1986 Feb;203(2):132-5. doi: 10.1097/00000658-198602000-00004.
Abstract
Nearly 30% of patients with Crohn's disease requiring operative treatment have severe peripheral lymphopenia. The surgical significance of this finding had not been previously determined. One hundred fifty-eight patients with Crohn's disease admitted for resection of the diseased bowel were studied. Forty-six had preoperative peripheral lymphocyte counts under 1000 cells per mm3. Severely lymphopenic patients had a significantly higher incidence of skip areas and epithelioid granulomas than patients with higher lymphocyte counts. Also, lymphopenic patients were more likely to require separate resections of the diseased bowel and more than one anastomosis. Postoperative follow-up revealed that patients with preoperative lymphopenia had a markedly higher incidence of symptomatic recurrences within 3 years of operation (67 vs. 36%, p less than 0.01). It appears that the preoperative peripheral lymphocyte count may be used as an indicator of disease severity and prognosis in patients with Crohn's disease.
摘要
近30%需要手术治疗的克罗恩病患者存在严重的外周淋巴细胞减少。这一发现的手术意义此前尚未确定。对158例因病变肠段切除而入院的克罗恩病患者进行了研究。46例患者术前外周淋巴细胞计数低于每立方毫米1000个细胞。淋巴细胞严重减少的患者跳跃区域和上皮样肉芽肿的发生率明显高于淋巴细胞计数较高的患者。此外，淋巴细胞减少的患者更有可能需要对病变肠段进行单独切除以及不止一次吻合。术后随访显示，术前淋巴细胞减少的患者在术后3年内出现症状复发的发生率明显更高（67%对36%，p<0.01）。术前外周淋巴细胞计数似乎可作为克罗恩病患者疾病严重程度和预后的指标。
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