炎症性肠病的临床和病理特征分析.docVIP

炎症性肠病的临床和病理特征分析 陈速李彦鹏黄爱轩尹少芳 广东省东莞市寮步医院 广东 东莞 523400 【摘要】 目的 回顾性分析炎症性肠病(IBD)的病理特征及其临床诊断符合 率,为提高IBD的诊断水平提供依据.方法 按照2 0 0 7年中华医学会消化病学 分会IBD诊治标准，选取1 9 9 8至2 0 1 4年木院住院2 3 0例IBD患者作为研 究对象，分为溃疡性结肠炎(UC,n= 1 8 0)和克罗恩病(CD,n= 5 0 )两组,回顾UC 和UC的病理特征并进行统计学分析?结果UC组病理检查诊断符合率为3 . 3 %,CD组病理检查诊断符合率为2 9 . 5 %，两者差异无显著性(p 0 . 0 );UC组病理检查率为5 0 . 8 %,CD组病理检查率为7 0?2 %，前者明显低于 后者(pV 0?0 5 );UC组主要病理表现，按发生率从高到低，依次为隐窝炎及隐窝 脓肿、糜烂与溃疡、杯状细胞减少、腺体增牛、基底浆细胞增多、隐窝扭曲与分 支、不典型增生、隐駕萎缩、绒毛状表面;CD组依次为急慢性炎症、非干酪样肉 芽肿、裂隙样溃疡?结论IBD临床诊断中进行病理检查例数较少，诊断符合率偏 低;UC病理特征以糜烂或溃疡及隐窝炎与隐窝脓肿为主,CD病理特征以非干酪样 肉芽肿与裂隙样溃疡为主;提示明确IBD的病理特征有利于提高IBD的诊断符合率. 【关键词】 溃疡性结肠炎；克罗恩病；病理 Analysis on pathologicalcharacteristicsa nddiagnosisofi nflammatoryboweldisease Che nSuLiYa npen gHua ngAixuan Yin Chua ngfaYin Shaofa ng (DepartmentofPa G thology,LiaobuHospital,Dongguan,Guangdong, 5 2 3 4 0 0) [Abstract】 ObjectiveToa nalysis on pathologicalcharactersa ndclinicaldiag no sisofi nflammatorybow eldisease(IBD)retrospectivelyinordertoprovidethebasistoimG provethelevelofdiagnosisofIBD. MethodsAccordingtothe 2 0 0 7 ChineseMedicalAssociationsta ndardIBDinthediag no sisa ndtreatmentofdigestivediseas e, 2 3 0 casesofhospitalizedIBDpatientsfrom 2000 to 20 14 inourhospitalwereselectedastheresearchobjecta nddividedintotwogroupssuchasForul cerativecolitis(UC,n= 1 8 0 )andCrohn sdisease(CD,n= 5 0 )? ThepathologicalcharacteristicsandclinicaldiagnosisofIBDwerereviewedandstatis ticallyanalyzed. ResultsThepathologydiagnosiscoincidencerateinUCandCDwere 2 ? 4 %and 2 7 . 5 %respectively,thedifferencebetweenthemisnotsignificant(p 0 . 0 5). TheCDgrouppathologicalexaminationrate( 7 0 ? 2 %)washighersignificantlythanthat( 5 0. 8 %)ofUCgroup(p 0 ? 0 ). ThemainpathologicalfeaturesofUCgroup,accordingtotheoccurrenceratefromhig htolow,werecryptitisandcryptabscess,erosi ono rulcecgobletcellsreduction^la ndhyper plasia,basalplasmacytosis,cryptaetwisti ngan dbra nching,atypicalhyperplasiai n,cryptae atrophy,fluffinesssurfaces. ThemicroscopicmanifestationsofCDgroupincludedactivec hronici n