17例儿童炎症性肠病临床特征分析

Analysis of clinical characteristics of 17 children with inflammatory bowel disease

目的探讨我科近1年来儿童炎症性肠病(IBD)的临床特征。方法收集我科2019年7月~2020年5月IBD住院患者的临床资料,对临床症状、实验室检查、临床分型、活动度评估、内镜、病理及治疗转归进行分析总结。结果溃疡性结肠炎(UC)和克罗恩病(CD)临床表现主要有发热、腹泻、腹痛、腹胀、关节炎及肛周病变等,其差异均无明显统计学意义(P>0.05);而CD呕吐、口腔溃疡较UC常见,且差异均有统计学意义(P<0.05)。临床分型上,UC组以初发型最多见(71.44%),病变部位主要是全结肠型(85.17%);CD组病变部位可累及全消化道,以回结肠最常见(60.00%)。活动程度评分中,UC以中度活动期为主(85.71%);CD轻度活动和中/重度活动各占50.00%。CD镜下可见纵行溃疡、鹅卵石样改变、跳跃性分布等病变。UC镜下可见弥漫充血、糜烂、溃疡,差异性两组比较,差异有统计学意义(P<0.05)。结论提高对儿童IBD的认知,综合评估,以期达到早期诊断及早期治疗,改善预后。

Objective To explore the clinical features of inflammatory bowel disease(IBD)in children in our department in the past one year.Methods The clinical data of IBD hospitalized patients from July 2019 to May 2020 were collected.The clinical symptoms,laboratory tests,clinical classification,activity evaluation,endoscopy,pathology and treatment outcomes were analyzed and summarized.Results The clinical manifestations of ulcerative colitis(UC)and Crohn's disease(CD)mainly included fever,diarrhea,abdominal pain,abdominal distension,arthritis,and perianal lesions.The differences were not statistically significant(P>0.05).CD vomiting and oral ulcers were more common than UC,and the differences were statistically significant(P<0.05).In terms of clinical typing,the most common type in UC group was the initial type(71.44%),and the lesion site was mainly the total colon type(85.17%);Lesions in group D may involve the whole digestive tract,with ileocolon being the most common(60.00%).In the activity level score,UC was mainly in the moderate activity period(85.71%).CD light activity and moderate/heavy activity accounted for 50.00%respectively.Under CD microscope,longitudinal ulcers,cobblestone changes,and leaping distribution were seen.Under UC microscopy,diffuse congestion,erosion and ulcer were observed,and the difference between the two groups was statistically significant(P<0.05).Diffuse hyperemia,erosion,and ulcers can be seen under UC microscope,and the difference between the two groups was statistically significant(P<0.05).Conclusion The cognition of IBD in children should be improved and comprehensive assessment should be made to achieve early diagnosis and treatment and improve prognosis.