摘要
目的探讨术前肠道超声参数预测克罗恩病患者术后早期复发(EPR)的价值。方法回顾性分析2015年3月至2020年12月于中山大学附属第六医院行Ⅰ期肠切除手术的克罗恩病患者95例, 根据术后1年内是否复发, 将患者分为EPR组(n=50)和NEPR组(n=45)。比较两组间术前肠道超声参数包括肠壁厚度、肠壁层次、血流分级、肠系膜脂肪增生(MFH)、肠系膜淋巴结肿大、脓肿/瘘管、腹腔积液及临床因素如术前C-反应蛋白(CRP)和红细胞沉降率(ESR)等的差异。分析两组间差异有统计学意义的超声参数对EPR的诊断效能。采用单因素及多因素Logistic回归分析筛选出与克罗恩病患者EPR相关的独立预测因素。结果随访1年内, 52.6%(50/95)的克罗恩病患者出现EPR。在临床因素中, EPR组与NEPR组术前CRP和ESR差异有统计学意义(均P<0.05)。在超声参数中, EPR组MFH和脓肿/瘘管的发生率高于NEPR组, 差异有统计学意义(均P<0.05)。MFH预测EPR的AUC高于脓肿/瘘管(0.797比0.617, P=0.002)。单因素Logistic回归分析结果显示, CRP、ESR、MFH和脓肿/瘘管是预测EPR的候选变量(均P<0.05)。多因素Logistic回归分析结果显示, MFH(OR=13.800, P<0.001)和CRP(OR=1.015, P=0.030)为EPR的有效预测因素。结论术前肠道超声参数MFH有助于预测克罗恩病患者EPR的风险。
Objective:To investigate the value of preoperative intestinal ultrasound parameters in predicting early postoperative recurrence(EPR)in patients with Crohn's disease(CD).Methods:Ninety-five patients with CD who underwent I-stage intestinal resection at the Sixth Affiliated Hospital,Sun Yat-sen University from March 2015 to December 2020 were retrospectively enrolled.The patients were divided into EPR group(n=50)and non-EPR(NEPR)group(n=45)based on recurrence within one year postoperatively.Differences in preoperative intestinal ultrasound parameters including bowel wall thickness,bowel wall stratification,color Doppler grading,mesenteric fat hypertrophy(MFH),mesenteric lymphadenopathy,abscess/fistula,abdominal effusion,and clinical factors such as preoperative C-reactive protein(CRP)and erythrocyte sedimentation rate(ESR)were compared between the two groups.The predictive values of ultrasound parameters with statistically significant differences between the two groups were analyzed.Univariate and multivariate Logistic regression analyses were used to identify independent predictive factors associated with EPR in patients with CD.Results:During the 1-year follow-up,EPR occurred in 52.6%(50/95)patients with CD.Among clinical factors,preoperative CRP and ESR levels showed statistically significant differences between the EPR and NEPR groups(all P<0.05).For ultrasound parameters,the incidences of mesenteric fat hypertrophy(MFH)and abscess/fistula were significantly higher in the EPR group than the NEPR group(all P<0.05).MFH demonstrated a significantly higher AUC value for predicting EPR compared to abscess/fistula(0.797 vs.0.617,P=0.002).Univariate Logistic analysis showed that CRP,ESR,MFH and abscess/fistula were candidate variables for diagnosing EPR(all P<0.05).Multivariate Logistic regression analysis indicated that MFH(OR=13.800,P<0.001)and the laboratory measure CRP(OR=1.015,P=0.030)were effective predictive factors for EPR.Conclusions:Preoperative intestinal ultrasound parameter MFH may serve as a valuable predictor for assessing EPR risk in patients with CD.
作者
梁焯华
周杰
程文捷
覃斯
刘广健
Liang Zhuohua;Zhou Jie;Cheng Wenjie;Qin Si;Liu Guangjian(Department of Medical Ultrasound,Biomedical Innovation Center,the Sirth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of Radiology,the Sirth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China)
出处
《中华超声影像学杂志》
北大核心
2025年第7期623-629,共7页
Chinese Journal of Ultrasonography
基金
广东省消化系统疾病临床医学研究中心项目(2020B1111170004)。
关键词
克罗恩病
术后早期复发
肠道超声
肠系膜脂肪增生
Crohn's disease
Early postoperative recurrence
Intestinal ultrasound
Mesenteric fat hypertrophy
