炎症性肠病的临床和病理特征分析陈速李彦鹏黄爱轩尹少芳广东省东莞市寮步医院广东东莞523400【摘要】目的回顾性分析炎症性肠病(IBD)的病理特征及其临床诊断符合率,为提高IBD的诊断水平提供依据.方法按照2007年中华医学会消化病学分会IBD诊治标准，选取1998至2014年木院住院230例IBD患者作为研究对象，分为溃疡性结肠炎(UC,n=180)和克罗恩病(CD,n=50)两组,回顾UC和UC的病理特征并进行统计学分析•结果UC组病理检查诊断符合率为34.3%,CD组病理检查诊断符合率为29.5%，两者差异无显著性(p>0.05);UC组病理检查率为50.8%,CD组病理检查率为70・2%，前者明显低于后者(pV0・05);UC组主要病理表现，按发生率从高到低，依次为隐窝炎及隐窝脓肿、糜烂与溃疡、杯状细胞减少、腺体增牛、基底浆细胞增多、隐窝扭曲与分支、不典型增生、隐駕萎缩、绒毛状表面;CD组依次为急慢性炎症、非干酪样肉芽肿、裂隙样溃疡•结论IBD临床诊断中进行病理检查例数较少，诊断符合率偏低;UC病理特征以糜烂或溃疡及隐窝炎与隐窝脓肿为主,CD病理特征以非干酪样肉芽肿与裂隙样溃疡为主;提示明确IBD的病理特征有利于提高IBD的诊断符合率.【关键词】溃疡性结肠炎；克罗恩病；病理AnalysisonpathologicalcharacteristicsanddiagnosisofinflammatoryboweldiseaseChenSuLiYanpengHuangAixuanYinChuangfaYinShaofang(DepartmentofPaGthology,LiaobuHospital,Dongguan,Guangdong,523400)[Abstract】ObjectiveToanalysisonpathologicalcharactersandclinicaldiagnosisofinflammatoryboweldisease(IBD)retrospectivelyinordertoprovidethebasistoimGprovethelevelofdiagnosisofIBD.MethodsAccordingtothe2007ChineseMedicalAssociationstandardIBDinthediagnosisandtreatmentofdigestivedisease,230casesofhospitalizedIBDpatientsfrom2000to2014inourhospitalwereselectedastheresearchobjectanddividedintotwogroupssuchasForulcerativecolitis(UC,n=180)andCrohn'sdisease(CD,n=50)•ThepathologicalcharacteristicsandclinicaldiagnosisofIBDwerereviewedandstatisticallyanalyzed.ResultsThepathologydiagnosiscoincidencerateinUCandCDwere24•4%and27.5%respectively,thedifferencebetweenthemisnotsignificant(p>0.05).TheCDgrouppathologicalexaminationrate(70・2%)washighersignificantlythanthat(50.8%)ofUCgroup(p<0・05).ThemainpathologicalfeaturesofUCgroup,accordingtotheoccurrenceratefromhightolow,werecryptitisandcryptabscess,erosionorulcecgobletcellsreduction^landhyperplasia,basalplasmacytosis,cryptaetwistingandbranching,atypicalhyperplasiain,cryptaeatrophy,fluffinesssurfaces.ThemicroscopicmanifestationsofCDgroupincludedactivechronicinflammation’non——caseatinggranulomaandfissuringulcer.ConclusionsThenumberofcasesundergoingpathologicalexaminationwasnotveryhigh,andthecoincidenceratewaslow.PathologicalcharacteristicsofUCweremainlyerosionorulcer,cryptitisandcryptabscess,whilethoseofCDweremainlynon—caseatinggranulomaandfissuringulcer’bothofwhichwereinactivechronicinflammationperiod•ItsuggeststhatexGplicit【pKatehyolwoogridcsal]charactersofIBDhelpstoimprovetheaccuracyrateofIBDdiagnosis.Ulcerativecolitis;Crohn’sdisease;Pathology【中图分类号】R574【文献标识码】B【文章编号】1008—6315(2015)10—0111—02炎症性肠病(inflammatoryboweldiseasesJBD)包括溃疡性结肠炎(ulcerGativecolitis,UC)和克罗恩病(Crohn7sdisease,CD)[1].近年来，我国IBD病例呈上升趋势，尤其在经济发展较快的城市和地区[2,3].在临床工作中，由于IBD的病理特征认识不足，对UC和CD的临床诊断与病理诊断的符合率还有待提高•本文选取本院近17年来收住的230例IBD患者(其中UC共180例,CD共50例)，回顾其病理组织学检查结果，总结分析UC和CD的临床和病理学特征，为提高IBD的临床诊断水平提供依据.1材料与方法1・1选取临床病例按照2007年中华医学会消化病学分会...
