摘要
目的探讨儿童炎症性肠病(IBD)的临床特点,以提高对儿童IBD的认识。方法对1995年1月-2005年12月本院收治的11例IBD患儿的临床资料进行回顾性分析。结果11例IBD患儿中克罗恩病(CD)8例,溃疡性结肠炎(UC)3例;男9例,女2例;发病年龄1个月～12岁9个月(中位年龄6岁)。11例IBD患儿均无阳性家族史。临床表现为贫血9例(81.8%),消瘦、腹痛各8例(72.7%),发热7例(63.6%),腹泻6例(54.5%),便血5例(45.5%)。实验室检查11例(100%)患儿均有CRP增高,ESR升高10例(90.9%),白细胞升高8例(72.7%)。病理结果表现为浅表小溃疡7例(63.6%)、黏膜慢性炎症6例(54.5%),患儿均未见非干酪样肉芽。其中10例予5-氨基水杨酸或柳氮磺胺吡啶、糖皮质激素治疗后缓解。结论IBD可在婴幼儿期发病,其诊断应根据临床表现、血液学指标、消化内镜及组织病理学等资料进行综合评价。如临床高度怀疑IBD,实验室检查虽无典型病理改变,在除外感染性疾病和其他自身免疫性疾病的基础上,可行诊断性治疗。
Objective To explore the clinical features of inflammatory bowel disease （IBD） in children and to improve the recognition of IBD in children.Method The clinical data of 11 pediatric inpatients with IBD,who were admitted to the First Affiliated Hospital of Sun Yat-Sen University from Jan.1995 to Dec.2005,were analyzed retrospectively.Results Among the 11 children with IBD,8 cases had Crohn＇s disease （CD） and 3 cases had ulcerative colitis （UC）.There were 9 male and 2 female.The age of onset ranged from 1 month to 12 years and 9 months.All cases had no positive family history of IBD.The clinical manifestations were anemia in 9 cases （81.8%）,abdominal pain in 8 cases （72.7%）,emaciation in 8 cases （72.7%）,fever in 7 cases （63.6%）,diarrhea in 6 cases （54.5%）,and bloody stool in 5 cases （45.5%）.C-reactive protein（CRP） levels were increased in all cases（100%）.Erythrocyte sedimentation rate（ESR） levels were increased in 10 cases （90.9%）.White blood cell counts were increased in 8 cases （72.7%）.The primary pathological changes were small ulcers in the superficial surface of intestinal mucosa in 7 cases （63.6%） and chronic inflammation in 6 cases （54.5%）.Non-caseating gra-nulomas were not observed in all cases.Ten cases＇ condition had been improved after 5-aminosalicylates or sulfasalazine,glucocorticoid therapy.Conclusions IBD may occur among infants.The diagnosis of IBD should depend on the patient＇s clinical manifestation,blood index,endoscopic and pathological information for a comprehensive evaluation.After infectious diseases and other autoimmune diseases were excluded,patients that were highly suspected of IBD but had no typical pathological changes might be given diagnostic treatment.
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2010年第7期495-496,共2页
Journal of Applied Clinical Pediatrics
关键词
炎症性肠病
克罗恩病
溃疡性结肠炎
儿童
inflammatory bowel disease
Crohn＇s disease
ulcerative colitis
child
