目的 评价国内外两种不同的克罗恩病(CD)内镜评分标准与CD临床疾病活动度以及两种评分标准间的一致性.方法 选择2007年7月至2011年8月在本院行内镜检查(全结肠镜或双气囊小肠镜)的CD患者共70例,按国内标准(CGSCD)与简化CD内镜评分(SESCD)两种评分标准由2位医师独立评价,并收集同期临床资料与实验室指标,数据处理使用SPSS 13.0.结果 SESCD与CGSCD两种评分标准之间具有显著的相关性,Spearman相关系数为0.776(P＜0.01).这两种内镜评分标准与血沉(ESR)、C反应蛋白、红细胞压积、血红蛋白、简化CDAI之间均有统计学意义的相关性(P＜0.05),但简化CD内镜评分标准与疾病临床活动度的相关性更大.两种内镜评分标准在治疗前后的变化值与ESR、CRP、HCT、HB、简化CDAI的变化值间均无统计学意义上的相关性(P＞0.05).结论 CD的两种内镜分级和评分标准具有显著的一致性,且与疾病临床活动度以及评价活动度的实验室指标均具有较良好的相关性,但与治疗前后疾病活动度变化并不一致.国内CD内镜分级标准尚待改进.%Objective To assess the agreement of two different endoscopic scoring systems for Crohn's disease (CD) and the correlation between these endoscopy grading and disease activity. Methods The data of seventy patients with an established diagnosis of CD, who underwent endoscopy (colonscopy or double balloon enteroscopy) in Shanghai Ruijin Hospital from July 2007 to August 2011, were evaluated with Chinese grading system (CGSCD) and simple endoscopic score for CD (SESCD) by two physicians independently. Data were analyzed with SPSS 13. 0. Clinical data and laboratory parameters over the same period were also collected. Results The agreement for the two endoscopic scoring systems was excellent, Spearman's correlation coefficient was 0. 776 (P<0. 01). Both endoscopic scoring systems had a significant correlation with erythrocyte sedimentation rate (RSR), C-reactive protein (CRP), hematocrit (HCT), hemoglobin (HB) and simple CD activity index (simple CDAD (P<0. 05), while SESCD was more relevant to clinical activity. There was no significant correlation between changes of these two endoscopic scoring systems after treatment with ESR, CRP, HCT, HB and simple CDAI. Conclusions There is significant concordance between these two endoscopic scoring systems, which both have satisfactory correlation with clinical activity and laboratory parameters. But these endoscopic scoring systems are not synchronized with the change of disease activity after treatment. CGSCD needs further improvement.
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