回肠末端炎的临床、内镜、病理学及病因学探讨

Appraisal of clinico-pathologic,endoscopic and etiologic study in terminal ileitis

目的：研究回肠末端炎的临床、内镜、病理学及超微结构、细菌学改变的特点及病因学。材料与方法：全部病例均行内镜及病理学检查，１５例作细菌学检查，７例作电镜检查。结果：１．本病的临床表现无特异性（Ｐ＞０．０５）；易与结肠疾病并存但又不同于小肠疾病。２．本病的内镜下改变与病理学改变一致。３．本病多有回盲瓣舒缩功能异常（Ｐ＜０．０１）。４．病灶处杯状细胞增多，吸收细胞变性或坏死。５．本病有细菌失衡：保护性细菌减少，且回盲瓣内外细菌改变一致（Ｐ＞０．０５）。结论：本文分析了本病临床、内镜、病理学的变化特点。推测本病可能与感染和免疫反应有关。同时指出，结肠－－回肠反流在本病发生中的重要作用．

Purpose∶To evalutate the clinico-pathologic,endoscopic,bacteriologic features of terminal ileits and its etiology. Materials and methods∶ 164 cases of terminal ileitis were deteacted by endoscope and pathology,15 by bacteriology,7 by electronmicroscopy. Results∶ (1) The clinical features were non-specific.(2)Endoscopic changes were consistent with micropatho- logy.(3) Most of them had abnormal contraction-relaexation function of ileo-cecal valve (P<0.0(4) At the foci, Goblet cells increased and resorption cells degenerated or necrotic. 5.Imbalance of bacteria flora,with beneficial bacteria reduced, the bacteric flora proximal to ileoceal valve was consistent with those distal to the valve. Conclusions It is speculated that the disease is related to infection and immune response,of the host,the colonal-ilec reflux probably plays an important role in the development of the diseases.