联合肠系膜血管超声造影的缺血性结肠炎临床分析

Clinical analysis of ischemic colitis combined with mesenteric angiography

目的:探讨缺血性结肠炎(IC)的临床特点,分析IC患者各生化指标、肠系膜CT血管造影(CTA)、肠系膜动脉超声造影与结肠镜下表现的关系。方法:回顾性分析2019年2月至2020年10月临床诊断为IC患者,根据结肠镜下表现分为轻症组和重症组,比较两组临床症状、生化检查、结肠镜病理结果、肠系膜CTA检查结果以及血管超声造影结果的差异。结果:结肠镜重症组血白细胞计数、凝血酶原时间、肌酐水平、C-反应蛋白(CRP)水平与轻症组比较差异有统计学意义(P<0.05),肠系膜动脉CTA阳性率在结肠镜轻症组和重症组间差异有统计学意义(P=0.014),肠系膜超声造影阳性率在结肠镜重症组与轻症组比差异无统计学意义(P=0.108)。所有入组患者肠系膜动脉CTA阳性率与肠系膜动脉超声造影阳性率之间差异有统计学意义(P=0.035)。结论:IC患者中结肠镜下表现差异与患者白细胞计数、凝血酶原时间、肌酐、CRP有关,肠系膜动脉CTA和肠系膜动脉超声造影应根据患者病情选择。

Objective:To investigate the clinical characteristics of ischemic colitis and analyze the relationship between biochemical indexes,mesenteric CTA,mesenteric artery contrast-enhanced ultrasonography and endoscopic manifestations.Methods:Patients who were clinically diagnosed with ischemic colitis from February 2019 to October 2020 were enrolled,who were divided as mild group and severe group according to colonoscopy manifestations.The differences between the two groups were investigated and compared in clinical symptoms,biochemical examination,pathology of colonoscopy,mesenteric CTA,and angiography results.Results:Blood leukocyte count,prothrombin time,creatinine level and CRP level were significantly higher in severe group than in mild group(P<0.05),with statistical difference in mesenteric artery CTA examination between the mild and severe groups(P=0.014).The positive rate of mesenteric contrast-enhanced ultrasound was higher in severe group than in mild group,with no significant difference(P=0.108).The difference between the positive rate of mesenteric artery CTA and the positive rate of mesenteric artery contrast-enhanced ultrasound was statistically significant in all enrolled patients(P=0.035).Conclusion:The colonoscopy difference in patients with ischemic colitis is significantly related to white blood cell count,prothrombin time,creatinine,CRP level.The choice between mesenteric artery CTA and mesenteric artery contrast-enhanced ultrasound should be based on the patient's condition.