發(fā)布時(shí)間：2018-06-04 00:02

  本文選題：克羅恩病 + 黏膜下層　； 參考：《廣西醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的初步探討超聲內(nèi)鏡(EUS)測(cè)量黏膜下層厚度對(duì)判斷克羅恩病(CD)活動(dòng)性的臨床價(jià)值。方法對(duì)10例臨床確診為活動(dòng)期CD的患者及10例同期健康對(duì)照者進(jìn)行結(jié)腸鏡及EUS檢查,觀察鏡下改變、記錄克羅恩病簡(jiǎn)易鏡下評(píng)分(SES-CD)及測(cè)量病變最重部位的黏膜下層厚度,隨訪并測(cè)量其緩解期相同病變部位黏膜下層厚度,對(duì)比CD患者治療前后黏膜下層厚度改變,分析黏膜下層厚度與CD活動(dòng)的相關(guān)性,并計(jì)算出黏膜下層厚度診斷CD活動(dòng)性的最佳閾值。結(jié)果10例CD患者活動(dòng)期黏膜下層厚度為(6.48±1.95)mm,緩解期為(2.47±1.08)mm(P0.01);相關(guān)性分析顯示黏膜下層厚度與克羅恩病活動(dòng)指數(shù)(CDAI)值呈正相關(guān)(r=0.708,P0.01),與SES-CD評(píng)分呈正相關(guān)(r=0.807,P0.01)。對(duì)10例EUS下黏膜下層厚度進(jìn)行受試者工作特征曲線分析,曲線下面積為0.985(P0.01)。當(dāng)黏膜下層厚度取3.85mm作為閾值時(shí),敏感度為100%,特異度為90%,Youden指數(shù)為0.90。結(jié)論EUS測(cè)量黏膜下層厚度有助于評(píng)估CD的活動(dòng)性,從而有助于指導(dǎo)臨床治療。
[Abstract]:Objective to evaluate the clinical value of submucosal thickness measurement by EUS in judging the activity of Crohn's disease (Crohn's disease). Methods the colonoscopy and EUS examination were performed in 10 patients with active CD and 10 healthy controls. The changes under microscope were observed. The score of SES-CDand the thickness of submucous membrane at the most serious site of Crohn's disease were recorded. The submucosal thickness of the same lesion was measured at the same stage of remission. The changes of submucosal thickness were compared before and after treatment in CD patients, and the correlation between submucosal thickness and CD activity was analyzed. The optimal threshold value of submucosal thickness for CD activity was calculated. Results the submucosal thickness of 10 patients with CD was 6.48 鹵1.95 mm in active stage and 2.47 鹵1.08 mm in remission stage (P 0.01). The correlation analysis showed that the thickness of submucosal submucosa was positively correlated with the activity index of Crohn's disease (CDAII), and positively correlated with the SES-CD score. The submucosal thickness of 10 patients with EUS was analyzed by the operating characteristic curve. The area under the curve was 0.985 (P 0.01). When 3.85mm was taken as the threshold, the sensitivity was 100 and the specificity was 90. The Youden index was 0. 90. Conclusion the measurement of submucosal thickness by EUS is helpful to evaluate the activity of CD and to guide clinical treatment.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R574.62

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