High incidence of upper gastrointestinal tract involvement in Crohn's disease
High incidence of upper gastrointestinal tract involvement in Crohn's disease
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DOI：
10.1007/s004280050133
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发表时间：
1998-01-01
期刊：
影响因子：
--
通讯作者：
Stolte, M
中科院分区：
文献类型：
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作者：
Oberhuber, G;Hirsch, M;Stolte, M
更好地定义克罗恩病的胃粘膜组织学可以更准确地估计克罗恩病累及上消化道的频率。在对792例已知克罗恩病患者的回顾性研究中，确定了十二指肠、十二指肠球部、胃窦和体部粘膜中与疾病相关的病变的发生率。克罗恩病在组织学上确定在胃窦中的41.5%，在身体中的37.1%，在十二指肠中的12.1%，在十二指肠球中的13%。在另外15%和17.4%的病例中，分别怀疑十二指肠和十二指肠球部的克罗恩病。在接受上消化道内镜检查但尚未确诊克罗恩病的患者中，局灶性胃炎的阳性预测值高达94%。因此，高比例的克罗恩病患者显示上消化道受累，主要累及胃窦。提示克罗恩病的局灶性胃炎在胃镜检查时不知道有克罗恩病的患者中有很高的阳性预测值。
A better definition of gastric mucosal histology in Crohn's disease permits a more accurate estimation of the frequency of upper gastrointestinal tract involvement in Crohn's disease. In a retrospective study of 792 patients with known Crohn's disease the incidence of lesions associated with the disease was determined in the duodenum, duodenal bulb, and gastric antrum and body mucosa. Crohn's disease was identified histologically in the antrum in 41.5%, in the body in 37.1%, in the duodenum in 12.1%, and in the duodenal bulb in 13%. In a further 15% and 17.4% of cases, Crohn's disease of the duodenum and duodenal bulb, respectively, was suspected. The positive predictive value of focal gastritis in patients undergoing upper endoscopy and not yet known to have Crohn's disease is as high as 94%. Thus, a high proportion of Crohn's disease patients show upper gastrointestinal tract involvement, with the major involvement in the antrum. Focal gastritis suggesting Crohn's disease turned out to have a high positive predictive value in patients not known to have Crohn's disease at the time of gastroscopy.