Angerson W J, Allison M C, Baxter J N, Russell R I
University Department of Surgery, Royal Infirmary, Glasgow.
Gut. 1993 Nov;34(11):1531-4. doi: 10.1136/gut.34.11.1531.
Endoscopic laser Doppler flowmetry was used to measure neoterminal ileal blood flow in 16 patients who had undergone ileocolonic resection for Crohn's disease and had since remained clinically and biochemically free of disease, and eight control patients who had undergone similar surgery for colonic carcinoma. Four patients with clinically active Crohn's disease of the terminal ileum were also studied. Neoterminal ileal recurrence in those with inactive Crohn's disease was graded endoscopically. The median and minimum of five local blood flow measurements performed in each patient were inversely correlated with the endoscopic recurrence grade (r = -0.52, p = 0.04 and r = -0.63, p = 0.01 respectively). Relative to the control group, median blood flow was non-significantly lower in the inactive Crohn's disease group as a whole (p > 0.05) but was significantly reduced in patients with active disease (p = 0.02). A progressive reduction in tissue perfusion may accompany recurrence of Crohn's disease while at a subclinical stage.
采用内镜激光多普勒血流仪对16例因克罗恩病接受回结肠切除术且术后临床和生化指标均无疾病复发的患者以及8例因结肠癌接受类似手术的对照患者进行回肠末端血流测量。对4例末端回肠克罗恩病临床活动期患者也进行了研究。对非活动期克罗恩病患者的回肠末端复发情况进行内镜分级。每位患者进行的5次局部血流测量的中位数和最小值与内镜复发分级呈负相关(分别为r = -0.52,p = 0.04和r = -0.63,p = 0.01)。相对于对照组,非活动期克罗恩病组整体的血流中位数降低但无统计学意义(p > 0.05),而活动期疾病患者的血流中位数显著降低(p = 0.02)。在亚临床阶段,克罗恩病复发可能伴随着组织灌注的逐渐降低。