累及消化道的白塞病临床表现及其消化内镜下特征分析

The endoscopic and clinical characteristics of gastrointestinal Behcet＇s disease

目的总结累及消化道的白塞病（BD）的临床表现和消化内镜下特征。方法对27例累及消化道的BD患者的临床资料及随访结果进行回顾性分析。结果累及消化道的BD以累及食管和回盲部最为常见，分别为74．1％（20／27）和59．3％（16／27）；最常见消化道外症状依次为口腔溃疡（85．2％）、生殖器溃疡（25．9％）、眼炎（7．4％）和皮肤损害（7．4％），消化道症状以胸骨后痛为主（48．1％，13／27）；消化内镜下均表现为溃疡，多数溃疡底部不平，溃疡周边有炎性反应，完全型BD与不完全型BD内镜下溃疡特点相似；病理表现以典型小血管炎为主（44．4％，12／27）。结论累及消化道BD的临床表现复杂，症状与累及部位不一定完全平行，少数患者以消化道表现为首发和唯一症状，部分患者可以出现严重并发症，内镜下病变有一定特点，消化科医师需提高对该病的认识。

Objective To investigate the endoscopic and clinical characteristics of gastrointestinal Behcet＇s disease （BD）. Methods We analyzed the clinical and follow-up data of 27 patients with gastrointestinal BD retrospectively. Results Most common locations involved were esophagus and ileocecum, 74. 1% （20/27） and 59. 3% （16/27）, respectively. The most common parenteral symptoms were oral ulcers （ 85.2% ）, genital ulcers （25.9%）, ophthalmitis （7.4%） and skin damage （7.4%）. The most common gastrointestinal symptom was chest pain （48. 1%, 13/27）. Ulcer was the basic endoscopic feature, most of which were with uneven bottom and peripheral inflammatory response. There was no difference in endoscopic features between typical BD and atypical BD. Pathology showed typical small vasculitis （44. 4%, 12/27）. Conclusion Clinical manifestations of intestinal BD vary. Symptoms are not necessarily consistent with the involved locations. A small number of patients with BD present with gastrointestinal symptoms as the first and only symptom, with serious complications in some patients. Physicians need to be fully aware of the disease.