克罗恩病合并肺结节三例报道并文献复习

Pulmonary nodules in patients with Crohn′s disease:three cases report and literature review

目的:总结克罗恩病(CD)合并肺结节的临床特征。方法:回顾性分析2019年1月至2019年12月中山大学附属第六医院收治的3例CD合并肺结节患者的临床特征及诊治过程,并以"pulmonary nodule"、"lung involvement"、"pulmonary manifestations"、"Crohn′s disease"、"inflammatory bowel disease"、"克罗恩病"、"肺结节"为检索词,检索PubMed、Medline、Embase、万方数据库、中国知网自1990年3月至2020年3月的文献,进行相关文献复习总结。结果:共检索到25篇相关报道。纳入3例CD患者,年龄14~36岁,男性2例,1例有小肠手术切除史;2例应用肠内营养(EEN)治疗后达到缓解,肠黏膜愈合,肺结节消失;1例激素治疗后炎症缓解,肺结节消失。结论:CD合并肺结节少见,胸部高分辨CT是首选检查方法,需要注意鉴别诊断,经肠内营养、激素治疗可诱导缓解肠道炎症,同时对肺部病变有治疗作用,一般预后较好。

Objective To summarize the clinical features of Crohn′s disease with pulmonary nodules.Methods Clinical course of diagnosis and treatment of three cases of Crohn′s disease with pulmonary nodules at The Sixth Affiliated Hospital,Sun Yat-sen University were retrospectively reviewed.Key words of"pulmonary nodule","lung involvement","pulmonary manifestations","Crohn′s disease","inflammatory bowel disease"were used to retrieve associated literatures from PubMed,Medline,Embase,Wanfang database and CNKI between March 1990 and March 2020.Associated literatures were summarized and reviewed.Results A total of 25 associated literatures were retrieved.Three cases were enrolled with aged 14-36 years old,two males,one with a history of small bowel resection.All patients achieved inflammatory remission and disappeared pulmonary nodule after enteral nutrition(EEN)for two and systemic steroids for one.Conclusion The Crohn′s disease with pulmonary nodules is uncommon.Chest high-resolution CT is the first choice of examination method.The differential diagnosis is very important.EEN and systemic steroids can induce and relieve inflammation and have therapeutic effect on the pulmonary nodules.The prognosis of Crohn′s disease with pulmonary nodules is usually good.