食管克罗恩病内镜特征分析

摘要

目的 探讨食管克罗恩病(Esophageal Crohn′s disease,ECD)的人口学特点及胃镜下病变特征.方法 回顾性分析我院2007 年1 月～ 2011 年12 月期间经上消化道内镜检查同时经活检组织病理学诊断并最后经综合评价诊断为ECD 病例的胃镜特点.结果 57 例ECD 患者中男性32 例(56.1%),女性25 例(43.9%),平均发病年龄(40.6 ± 11.6)岁,ECD 在男女性别中的检出率差异没有统计学意义(χ2 ＝2.092,P = 0.148),内镜下溃疡形态主要为纵行溃疡24 例(42.1%)、火山口样溃疡21 例(36.8%)、鹅口疮样溃疡14 例(24.6%)、环形溃疡4 例(7.0%),胃镜下ECD 患者食管溃疡分布状况表现为跳跃性分布30(52.6%)例,呈单发分布24(42.1%)例;食管上段、食管中段及食管下段受累比例分别为:12.3% 63.2%36.8%.结论 食管克罗恩病好发于中青年人群,发病未见性别差异,胃镜下病变特征呈非特异性,主要累及食管中段,火山口样溃疡在食管较为多见,胃镜检查有助于食管克罗恩病受累程度及范围的评估.本研究为CD 的诊断、鉴别提供了依据和指导.%Objectives The objective of this study was to investigate demography of endoscopic characteristics in esophageal Crohn′s disease (ECD). Methods From Jan. 2007 to Dec. 2012, 57 ECD patients′ endoscopic features were analyzed by endoscopic and histopatholgic test, retrospectively. Results Among 57 cases of ECD patient, the detective rate had no significant difference between male (32, 56.1%) and female(25, 43.9%) (χ2 = 2.092, P = 0.148). The average age of the ECD patients was 40.6 ± 11.6 years old. Among the patients, we found 24 cases of longitudinal ulcers (42.1%), 21 cases of crater-like ulcers (36.8%) and 14 cases of aphthoid ulcer(24.6%) according endoscopic feature; 30 cases of noncontinuous ulcer(52.6%) and 24 cases of single ulcers (42.1%). The proportion of invasion on upper, middle and lower esophagus was 12.3%, 63.2% and 36.8%, respectively. Conclusions ECD preferentially affects young adult and has no significant sexual difference. The endoscopic characteristics registers as frequent crater-like ulcers and nonspecific lesions, which mainly involved in middle esophagus. Endoscopy is an effective tool to evaluate progression and range of ECD.