胃肠道结核的诊治进展

Progress in diagnosis and treatment of gastrointestinal tuberculosis

胃肠道结核是一种主要的肺外结核,可累及食管、胃、十二指肠、小肠、结肠、直肠、肛门,其症状存在非特异性,且与其他胃肠道疾病(如炎症性肠病、肿瘤等)难以鉴别。虽然目前核酸扩增试验等一系列新兴分子和免疫诊断方法迅速发展,但单一的实验室检查方法难以实现快速准确诊断胃肠道结核,需结合临床表现、影像学、组织病理学及多种核酸扩增试验来最终明确诊断。早期诊断并开始抗结核治疗以及及时的手术治疗对于降低患者病死率至关重要。作者综述了胃肠道结核的病因、临床特征、实验室检查和治疗策略,以期提高对本病的早期诊断和治疗。

Gastrointestinal tuberculosis is a main extrapulmonary tuberculosis that can affect the esophagus,stomach,duodenum,small intestine,colon,rectum and anus.The symptoms of gastrointestinal tuberculosis are non-specific and difficult to differentiate from other gastrointestinal diseases(such as inflammatory bowel disease,tumors,etc.).Although a series of emerging molecular and immunodiagnostic methods such as nucleic acid amplification test have developed rapidly,it is difficult to rapidly and accurately diagnosis gastrointestinal tuberculosis by a single laboratory examination method and the final diagnosis should be made based on combination of clinical manifestations,imaging,histopathology,and multiplenucleic acid amplification test.Early diagnosis and initiation of anti-tuberculosis therapy as well as prompt surgical treatment are essential to reduce the mortality.The authors review the etiology,clinical features,laboratory test and treatment strategies of gastrointestinal tuberculosis,in order to improve the early diagnosis and treatment of this disease.