摘要
目的:研究小肠胶囊内镜在儿童克罗恩病中应用的安全性和应用价值。方法:回顾性分析2016年1月至2021年12月经首都儿科研究所附属儿童医院消化内科诊断为克罗恩病并进行胶囊内镜检查的患儿的临床资料、胶囊内镜完成情况及相关化验检查结果。通过胶囊内镜的Lewis评分评估患儿小肠黏膜炎症活动度，并分析其与临床积分、生物标志物及多种细胞因子水平之间的关系。结果:纳入22例患儿共进行33例次胶囊内镜检查，其中，男患儿21例次、女患儿12例次，年龄7~16岁、平均年龄(11.27±2.10)岁，体重17~74 kg、平均体重(40.06±17.17)kg。患儿全部自主吞咽胶囊，除1例外均完成全小肠检查。所有患儿未发生胶囊滞留、胶囊嵌顿等并发症。肠道准备及胶囊内镜检查阶段部分患儿有轻度不适，可自行缓解。32例次发现部分小肠黏膜水肿，27例次发现不同程度的小肠溃疡，6例次发现息肉样增生，3例次小肠黏膜病变呈卵石样改变。Lewis评分分值为0~1404分，非活动期≤135分的9例、轻度黏膜炎性反应135~790分的19例、中-重度黏膜炎性反应≥790分的5例。Lewis评分与pCDAI评分具有相关性，与血IL-2受体水平具有相关性。结论:克罗恩病患儿能够安全地接受胶囊内镜检查，可通过CE对病情进行有效地评估，为治疗提供参考。
Abstract
Objective:To study the safety and value of small intestinal capsule endoscopy(CE) in children with Crohn′s disease(CD).Methods:We reviewed the clinical data, CE data and relevant laboratory examination results of patients with CD diagnosed in the Department of Gastroenterology from January 2016 to December 2021.Lewis score of CE was used to evaluate the inflammatory activity of small intestinal mucosa, and the relationship between it and clinical scores, biomarkers and levels of various cytokines was analyzed.Results:A total of 33 cases of CE tests were performed in 22 patients.Ages range from 7 to 16 years old, average age (11.27±2.10) years old. Weight ranged from 17 to 74 kg with average of (40.06±17.17) kg. All patients swallowed the capsule independently, and all completed the whole intestine examination except 1 case.No complications such as capsule retention and capsule incarceration occurred.During intestinal preparation and CE test, some patients reported gastrointestinal discomfort and could relieved themselves.Intestinal mucosal edema was found in 32 cases, intestinal ulcer of different degrees was found in 27 cases, polypoid hyperplasia was found in 6 cases, and pebble like changes were found in 3 cases of intestinal mucosal lesions. The Lewis score of capsule endoscopy was 0-1404 points, 9 cases with inactive period ≤135 points, 19 cases with mild mucosal inflammatory reaction 135-790 points, and 5 cases with moderate to severe mucosal inflammatory reaction ≥790 points.Lewis score was correlated with pCDAI score and circulating IL-2R level.Conclusion:CE is safe for children with CD, which can effectively evaluate the condition and provide reference for treatment.
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