摘要
目的对肠结核(IT)与克罗恩病(CD)进行临床及内镜分析和比较,以期找出对鉴别诊断有帮助的要点。方法采用回顾性方法,对既往确诊的肠结核30例与克罗恩病24例资料进行复习,分析其临床表现、放射影像学、内镜和组织病理学特征的异同之处。结果肠结核腹水形成更常见(53.3%)。B超或CT下IT肠系膜淋巴结肿大12/30例(40%),CD肠系膜淋巴结肿大2/24例(8.3%)。肠镜下表现及病理包括病变常见部位、节段性病变、横形溃疡、息肉形成情况、上皮样肉芽肿两组比较差异均无显著性。IT组肠镜下活检黏膜标本结核菌PCR阳性率22/30例(73.3%)。结论IT与CD的鉴别需要多方面综合判断,活检黏膜结核菌PCR有助于鉴别诊断。
Objective To explore the main points which are beneficial for differential diagnosis between Crohn＇ s disease （CD） and intestinal tuberculosis （IT） by clinical analysis. Methods 30 cases of TB and 24 cases of CD were investigated retrospectively during 1980-2007 in our hospital to compare the clinical,endoscopic and histopathologic features. Results Ascites and fever occurred more often in IT than in CD. The mesenteric lymphadenectasis was more significant in IT than in CD （40% vs 8.3 % ） （ P 〈 0. 05 ）. There were little value for differential diagnosis in colon endoscopy and histopathology manifestations, including the bowels involved, segmental changes, circular ulcers,pseudopolyps and epithelioid guanulomas. The positive rates of TB-PCR in endoscopic biopsy specimens was higher in IT than in CD （73.3% vs 12.5% ） （ P 〈 0.01 ）. Conclusions It is essential to take an overall consideration in differential diagnosis between CD and IT. PCR in endoscopic biopsy specimens is helpful in differential diagnosis between IT and CD.
出处
《中国临床保健杂志》
CAS
2009年第4期362-364,共3页
Chinese Journal of Clinical Healthcare
关键词
结核
胃肠
CROHN病
诊断
鉴别
Tuberculosis, gastrointestinal
Crohn disease
Diagnosis, differential
