微观性结肠炎:刺激性肠综合征患者的诊断挑战
Flaviu Rusu1, Roxana Luiza Caragut2, Lorena Camelia Mocanu3
1Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca; Cluj County Clinical Emergency Hospital, 3rd Department of Internal Medicine Cluj-Napoca, Romania. flaviurusu@yahoo.com.
微观性结肠炎 (MC) 经常被误诊为腹刺激性肠综合征 (IBS-D). 这项研究在11.2%的IBS-D患者中发现了MC,便中calprotectin水平较高,与炎症严重程度相关.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 病理学 病理学 病理学
背景情况:
- 刺激性肠综合征 (IBS) 是一种常见的胃肠疾病,通过罗马第四标准诊断.
- 微观性大肠炎 (MC),包括原性和淋巴细胞性大肠炎,导致慢性水性腹,在IBS患者中难以诊断.
- 在临床上,MC可被误诊为带腹的IBS (IBS-D),这凸显了需要准确的诊断方法的需要.
研究的目的:
- 为了确定最初被诊断为IBS的患者中MC的患病率.
- 为了将便calprotectin水平与内镜检测结果和MC中的微观炎症相关联.
- 改善MC的早期和正确诊断,以有效治疗患者.
主要方法:
- 在89名被诊断患有IBS主导性腹 (IBS-D) 或混合IBS (IBS-M) 的患者进行了回顾性研究,使用罗马IV标准.
- 患者接受了全结肠镜检查和多次活检,并测量了便中的calprotectin水平.
- 数据分析的重点是确定MC患病率,并将calprotectin水平与组织学发现相关联.
主要成果:
- 显微性结肠炎 (MC) 在89名IBS-D患者中被诊断为10名 (11.2%).
- 与没有微观病变的患者相比,MC患者的便calprotectin水平更高.
- 在MC患者中,calprotectin水平与结肠微观炎症的程度存在相关性.
结论:
- 微观性结肠炎 (MC) 是慢性腹的一个未被认可的原因,可能被误诊为IBS-D.
- 高便calprotectin水平可以帮助区分MC和IBS-D.
- 早期和准确的MC诊断对于适当的治疗和管理至关重要.
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