胶囊内镜对克罗恩病诊疗价值的探讨

The clinical value of capsule endoscopy for diagnosis and treatment of Crohn＇s disease

目的研究胶囊内镜对克罗恩病的诊断、指导治疗及预后的价值。方法对4例确诊和22例临床拟诊的克罗恩病患者行胶囊内镜检查，前瞻性分析检查后发现克罗恩病病变位置、指导治疗药物的变化，通过随访1年了解患者疾病活动的变化，分析治疗是否有效。结果胶囊内镜检查后发现小肠病变累及率由57．7％变为80．8％，而对症治疗减少，激素、免疫抑制剂应用明显增加。通过1年随访，22例拟诊克罗恩病患者中12例改为确诊，2例被排除。C反应蛋白（CRP）、克罗恩病活动指数（CDAI）、炎症性肠病生存质量问卷（IBDQ）、刘易斯评分（Ls）基线值及复查数值分别进行方差分析，P值均〈0．05，即治疗有效。结论胶囊内镜检查有益于克罗恩病的确诊、指导治疗及预后。

Objective To evaluate the value of capsule endoscopy（CE） in diagnosis, management and prognosis of crohn＇s disease（CD）. Methods Four diagnosed CD patients and 22 patients with suspec- ted CD underwent CE. The lesion location and drug therapy were analysed prospectively. Follow-up of one year was conducted to evaluate the disease and the effectiveness of therapy. Results There was an increase in detection rate of small bowel involvement, namely, from 57.7% to 80. 8% , and a decrease in symptomatic treatment and an increase in medication of hormone and immune inhibitors. After the follow-up of 12 months, 12 suspected CD patients were confirmed, and 2 patients were excluded. Variance analysis of CRP, CDAI, IBDQ and LS were conducted by repeated measures （P 〈 0. 05） and that meant the therapy was effective. Conclusion CE is useful for diagnosis, treatment and prognosis of CD.