共聚焦激光显微内镜与普通结肠镜对溃疡性结肠炎患者炎症活动度及黏膜屏障功能改变的判定价值比较

The comparison of confocal laser microscopy and common colonoscopy to determine changes in inflammatory activity and mucosal barrier function in ulcerative colitis patients

目的:比较共聚焦激光显微内镜(CLE)与普通结肠镜对溃疡性结肠炎(UC)患者炎症活动度及黏膜屏障功能改变的判定效果。方法:采用CLE的白光模式和显微模式分别对CLE组(n=40)和对照组(n=40)UC患者进行实时观察,记录两组患者的炎症活动度,评价2种方法的准确度、灵敏度和特异度;在进行荧光素渗透试验后,记录两组患者的正常肠段和异常肠段数量,并完成荧光素渗透评分。结果:两组患者正常、轻中度、重度检测结果差异具有统计学意义(P<0.05),且CLE组炎症活动度的灵敏度、特异度、准确度度均显著高于对照组(P<0.05);CLE组和对照组的功能正常肠段和异常肠段数量差异无统计学意义(P>0.05),CEL组荧光素评分则差异有统计学意义(P<0.05),2项评分均显著高于对照组。结论:采用CLE技术诊断UC患者的炎性活动度具有较高的灵敏度、准确度和特异度,同时该技术也能特异性评估患者结肠黏膜屏障功能改变情况,对于指导临床诊断具有较高的应用价值。

Objective:To compare the evaluating value of confocal laser microscopy(CLE)with common colonoscopy on the changes of inflammatory activity and mucosal barrier function in patients with ulcerative colitis(UC).Methods:The white light mode and microscopic mode of CLE were used to observe UC patients in CLE group(n=40)and control group(n=40)in real time,and the inflammatory activity of the two groups was recorded.The accuracy,sensitivity and specificity of the two methods were evaluated.After the luciferin permeation test,the number of normal and abnormal intestinal segments in the two groups of patients was recorded,and the luciferin permeation score was completed.Results:There were significant differences in normal,mild,moderate and severe test results between the two groups(P<0.05),and the sensitivity,specificity and sensitivity of inflammatory activity in CLE group were significantly higher than those in the control group(P<0.05).There was no significant difference in the number of normal and abnormal intestinal segments between CLE group and control group(P>0.05),while there was a significant difference in luciferin score(P<0.05).Both scores in CEL group were significantly higher than those in control group.Conclusion:CLE technique has high sensitivity,accuracy and sensitivity in the diagnosis of inflammatory activity in UC patients,and it can also specifically evaluate the changes of colonic mucosal barrier in patients,which has a high application value in guiding clinical diagnosis.