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目的探讨经肠镜微探头超声(MPS)检查评估溃疡性结肠炎(UC)疗效的临床价值。方法选择2014年1月至2016年12月在南方医科大学附属南海医院经临床表现、内镜及组织学检查证实为轻中度UC患者34例为研究组,门诊健康体检者15例为对照组。UC确诊后予美沙拉嗪治疗12周,研究组治疗前后及对照组均行MPS和超敏C反应蛋白(hs-CRP)检测,MPS观察指标为管壁总厚度(TWT)、黏膜层(M)和黏膜下层(SM)的厚度。结果共31例UC患者完成观察。UC组患者经美沙拉嗪治疗12周后临床及内镜下表现均较治疗前有显著改善。UC组治疗前TWT、M、SM厚度和hs-CRP水平与对照组和治疗后比较,差异均有统计学意义(P均<0.05),UC组治疗后M厚度与对照组比较差异有统计学意义(P<0.05),而TWT、SM厚度与对照组比较均无统计学差异(P均>0.05)。UC组治疗前hs-CRP水平与对照组和治疗后比较均有统计学差异(P均<0.05),治疗后hs-CRP水平与对照组比较无统计学差异(P>0.05)。结论 MPS通过观察结肠壁层次结构的变化,操作简单、安全,对于评估UC患者的疗效和判断缓解具有指导意义。
Objective To investigate the clinical value of endoscopic ultrasonography (MPS) in the evaluation of the curative effect of ulcerative colitis (UC). Methods From January 2014 to December 2016, 34 patients with mild-to-moderate UC were confirmed by endoscopic and histological examination in South China Sea Hospital affiliated to Southern Medical University from January 2014 to December 2016. Fifteen healthy subjects were selected as control group . UC patients were treated with mesalazine for 12 weeks. MPS and hs-CRP were detected in the study group before and after treatment. The MPS indicators included total wall thickness (TWT), mucosal layer (M ) And submucosa (SM) thickness. Results A total of 31 cases of UC patients completed the observation. After 12 weeks treatment with mesalazine, the clinical and endoscopic findings in UC patients were significantly improved compared with those before treatment. The levels of TWT, M, SM and hs-CRP before treatment in UC group were significantly different from those in control group and post-treatment group (all P <0.05). The difference of M thickness between UC group and control group after treatment was statistically significant (P <0.05). However, there was no significant difference in TWT and SM between the two groups (P> 0.05). The level of hs-CRP in UC group before treatment was significantly different from that in control group and after treatment (all P <0.05). There was no significant difference in hs-CRP level between the two groups (P> 0.05). Conclusions MPS can be used as a guide to evaluate the curative effect and judgment of remission of UC patients by observing the changes of colonic structure.