摘要
背景:克罗恩病(CD)是一种全胃肠道节段性、全壁层炎症性病变,其病因不明,临床表现多样。目的:探讨CD的临床特点、实验室指标和内科治疗进展,以期提高对CD的诊断和治疗水平。方法:对南京大学医学院附属鼓楼医院2000年1月～2005年8月住院病例中85例出院诊断为CD患者的临床表现、诊断方法和治疗进行总结和回顾性分析。结果:CD好发于男性,以青壮年为主,呈慢性病程。病变主要位于回结肠(52.9%),临床表现以腹痛(72.9%)、腹泻(56.5%)为主,结肠镜检查显示病变呈节段性,溃疡多见。简化CD活动指数(CDAI)评分与血沉(ESR)的相关系数为0.400(P<0.01),与白细胞计数的相关系数为0.239(P<0.05),与血小板计数的相关系数为0.454(P<0.01),与血小板平均容积的相关系数为0.287(P<0.01)。内科治疗对大多数病例有效,予5例复发性CD患者自体造血干细胞移植治疗,有4例缓解,1例术后6个月复发。结论:CD的发病率近年来逐年增高,诊断以临床表现结合结肠镜检查为主,ESR、白细胞计数、血小板计数和血小板平均容积可作为评估疾病活动度的参考指标。CD以内科治疗为主,顽固复发型CD患者可考虑行造血干细胞移植治疗。
Background： Crohn＇s disease （CD） is a segmental transmural inflammatory disease of gastrointestinal tract. So far its cause remains unclear, and the clinical manifestations are variegated. Aims： To appraise the clinical features, laboratory parameters and advances in the therapy of Crohn＇s disease. Methods： Eight-five inpatients of Drum Tower Hospital diagnosed as CD from January 2001 to August 2005 were enrolled. Their clinical manifestations, diagnostic methods and therapy were retrospectively analyzed. Results： CD was more common in young adults, with male preponderance, and running a chronic course. Its main clinical manifestations were abdominal pain （72.9%） and diarrhea （56.5%）, and the pathological lesions located were most frequently ileocolic （52.9%）. The common colonoscopic findings were segmental involvement and ulcerations. CD activity index （CDAI） had a significant correlation with erythrocyte sedimentation rate （ESR）, white blood cell count, platelet count and average size of blood platelets, the relative coefficients were 0.400 （P〈0.01）, 0.239 （P〈0.05）, 0.454 （P〈0.01） and 0.287 （P〈0.01）, respectively. Medical therapy was effective in most cases. We have conducted autologous hematopoietic stem cell transplantation in 5 patients with refractory CD and four of them had a sustained remission, one patient developed a recurrence of active CD 6 months after the stem cell transplantation. Conclusions： The incidence of CD has been increasing in recent years. Its diagnosis depends on clinical manifestations and colonoscopic findings. ESR, white blood cell count, platelet count and the average size of blood platelets can be used as references for estimation of disease activity. The treatment of CD is mainly on medical therapy, and autologous hematopoietic stem cell transplantation can be considered in those patients with refractory CD.
出处
《胃肠病学》
2006年第4期222-225,共4页
Chinese Journal of Gastroenterology
关键词
CROHN病
临床表现
诊断
造血干细胞移植
移植
自体
Crohn Disease
Clinical Features
Diagnosis
Hematopoietic Stem Cell Transplantation
Transplantation, Autologous
