摘要
目的分析婴儿型炎症性肠病(IO-IBD)的临床表现和实验室检查的变化特征。方法选取首都儿科研究所附属儿童医院消化内科2018年1月至2022年12月收治的27例IO-IBD患儿作为IBD组,另选取同期首都儿科研究所附属儿童医院收治的61例食物蛋白诱导的直肠结肠炎(FPIP)患儿作为对照组。比较分析两组患儿的临床表现及实验室检查指标。采用多因素logistic回归分析探讨影响IO-IBD发生的独立危险因素。结果两组患儿的性别、年龄以及临床表现(便血、腹泻的发生率)和腹泻次数比较,差异均无统计学意义(P>0.05)。在肠道超声检测方面,IBD组发生肠壁增厚和肛周病变的患儿比例均高于对照组,差异有统计学意义(P<0.05)。IBD组患儿发病到确诊时间长于对照组,体重指数低于对照组,差异有统计学意义(P<0.05)。IBD组的白细胞计数、血小板计数、C反应蛋白、红细胞沉降率、白介素-6、白介素-10水平高于对照组,而白蛋白低于对照组,差异有统计学意义(P<0.05)。采用R语言(4.3.2版本)进行多因素logistic回归分析,结果显示,校正前和校正后,白细胞计数升高,血小板计数升高、C反应蛋白升高、红细胞沉降率升高、白蛋白降低、白介素-6升高均是IO-IBD发生的独立危险因素(P<0.05)。结论临床表现为长期腹泻、便血的婴儿,应注意IO-IBD的可能,尤其是合并有营养不良、肠壁增厚、肛周病变等情况时,IO-IBD的可能性更大,建议尽早完善结肠镜检查及基因检测以明确诊断。白细胞计数、C反应蛋白、血清白介素-6和白蛋白水平可作为鉴别诊断IO-IBD与FPIP的指标。
Objective To analyze the clinical and laboratory test of infantile-onset inflammatory bowel disease(IO-IBD).Method 27 cases with IO-IBD and 61 infants with food protein-induced proctocolitis(FPIP)were retrospectively analyzed,who were admitted to the Children’s Hospital Affiliated to Capital Institute of Pediatrics from January 2018 to December 2022.The two groups were compared in terms of clinical manifestations and laboratory examinations.Logistic regression analysis was used to determine the risk factors of IO-IBD.Result There were no significant differences in gender,age,clinical manifestations and diarrhea frequency between the two groups.The BMI of IBD group was significantly lower than that of the control group.The time from onset to diagnosis in IBD group was significantly longer than that in the control group.In the detection of intestinal wall thickening and perianal lesions by intestinal ultrasound,the IBD group was higher than that of the control group,and the difference was statistically significant(P<0.05).The white blood cell count,platelet count,CRP,erythrocyte sedimentation rate,IL-6 and IL-10 in IBD group were significantly higher than those in FPIP group.The albumin of IBD group was significantly lower than that of FPIP group.Multivariate logistic regression analysis showed that the increase of peripheral white blood cells,CRP,IL-6 and albumin were the risk factors for IO-IBD(P<0.05).Conclusion Infants with long-term diarrhea and bloody stool should pay attention to the possibility of IO-IBD,especially combined with malnutrition,intestinal wall thickening and perianal lesions.It is recommended to improve colonoscopy and genetic testing as soon as possible to confirm the diagnosis.WBC,CRP,serum IL-6 and albumin levels can be used to distinguish IO-IBD from FPIP.
作者
廖伟伟
钟雪梅
宫幼喆
王姣
张姌
王福萍
牛文全
Liao Weiwei;Zhong Xuemei;Gong Youzhe;Wang Jiao;Zhang Ran;Wang Fuping;Niu Wenquan(Children's Hospital Affiliated to Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国医刊》
CAS
2024年第6期620-623,共4页
Chinese Journal of Medicine
基金
首都儿科研究所所级科研项目(LCYJ-2023-21)。
关键词
炎症性肠病
婴儿
食物蛋白诱导的直肠结肠炎
临床特征
Inflammatory bowel disease
Infant
Food protein-induced proctocolitis
Clinical features