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Dig Dis Sci:股静脉壁厚度可能是区分白塞病与肠道受累的克罗恩病的独特诊断工具

2021-07-30 MedSci原创 MedSci原创

白塞病(BD)是一种以全身性炎症为特征,特别是以口腔和生殖器溃疡、眼部表现和全身受累为主,但有时候也会累及肠道。

      白塞病(BD)是一种以全身性炎症为特征,特别是以口腔和生殖器溃疡、眼部表现和全身受累为主,但有时候也会累及肠道,而主要以胃肠道系统受累于 IBD (GIBD) 通常表现为腹痛,然后是腹泻,出血、呕吐、排便习惯改变。由于相似的临床表现,在出现非特异性胃肠道 (GI) 表现的年轻成人中,白塞病 (BD) 和克罗恩病 (CD)在临床上无法被轻易地区分。有研究表明,股总静脉 (CFV) 厚度增加是 BD 的一个显着特征,很少出现在其他炎症或血管疾病中,其临界值≥0.5 mm 的特异性高于 80%。因此,是否可以使用超声 (US) 测量 CFV 厚度作为 BD 的诊断工具呢。本项研究旨在评估CFV测量在BD和克罗恩病(CD)鉴别诊断中的诊断性能。

 

       本项研究共包括 BD ( n  = 69)、CD ( n  = 38) 和健康对照 (HC) ( n  = 38) 的不同患者。双侧 CFV 厚度用多普勒超声测量,然后使用相关性分析鉴定CFV 厚度在诊断不同疾病中的效能。

 

 

      研究结果显示与 HC 和 CD 相比,BD 的右侧和左侧 CFV 厚度均显着更高(右侧:0.76 毫米 VS  0.33 毫米,左侧:0.78 毫米 VS 0.35 毫米,p < 0.001)。CD 中的 CFV 厚度与 HC 相似( p > 0.05)。无论胃肠道(GI)是否受累的BD患者的CFV厚度也相似(p = 0.367)。≥ 0.5 mm 的 CFV 厚度的诊断临界值在区分 CD 和 HC 方面表现良好。HC 和 CD 的敏感性和特异性率 > 85%。

图:不同患者CFV的厚度差异

      本项研究发现与 BD 相比,CD 中的 CFV 厚度显着降低。因此,CFV 壁厚测量是区分 BD 和 CD 的独特诊断工具,有助于临床医生在日常实践中区分两种疾病。

 

 

原始出处:

Fatma Alibaz-Oner. Et al. Femoral Vein Wall Thickness Measurement May Be a Distinctive Diagnostic Tool to Differentiate Behçet’s Disease with Intestinal Involvement and Crohn’s Disease. Digestive Diseases and Sciences.2021.

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    2021-11-11 fusion
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    2021-07-29 李建斌

    三联征机制有待于进一步研究

    0

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