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目的对克罗恩病(CD)与原发肠道淋巴瘤(PIL)进行临床比较,找出对鉴别诊断有帮助的要点。方法回顾性分析我院1983年1月-2004年7月间CD 90例和PIL 46例住院患者,所有数据采用X2检验、t检验或非参数秩和检验。结果 PIL患者平均年龄高于CD患者近10岁[(45．0±16．2)岁比(36．7±15．7)岁,P<0．01],而PIL患者的病程中位数明显短于CD患者(4．0个月比36．0个月, P<0．01)。肛周病变在CD患者中多见(P<0．01)。肠梗阻及瘘管形成在CD患者更常见(P< 0．05)。60．9％PIL患者为单部位受累,明显高于CD患者(P<0．05)。腹部包块、腹腔淋巴结肿大和腹腔积液在PIL患者中多见(P<0．05),共有69例CD及20例PIL患者行消化道造影,显示PIL中充盈缺损、管壁僵硬、肠套叠多于CD(P<0．05)。共有67例CD及18例PIL患者接受内镜检查,活检确诊PIL占61．1％,而82．1％CD提示为非特异性炎性改变。CD和PIL的术前确诊率分别为17．7％和25．0％。结论 CD与PIL的诊断与鉴别诊断难度高,年轻而病程长、有肛周病变、瘘管形成、多部位病变者更支持CD,病情易复发;PIL病程短,单部位病变,内镜活检率确诊较高。
Objective To compare the clinical manifestations of Crohn’s disease (CD) with primary intestinal lymphoma (PIL) and find out the main points helpful in differential diagnosis. Methods The data of 90 inpatients with CD and 46 inpatients with PIL from January 1983 to July 2004 in our hospital were retrospectively analyzed. All the data were tested by X2 test, t test or non-parametric rank sum test. Results The average age of patients with PIL was significantly higher than that of CD patients at the age of 10 years (45.0 ± 16.2 years vs 36.7 ± 15.7 years, P <0.01). The median duration of PIL patients Significantly shorter than CD patients (4.0 months vs 36.0 months, P <0.01). Perianal lesions were more common in CD patients (P <0.01). Ileus and fistula formation were more common in CD patients (P <0.05). 60.9% of PIL patients were single site involvement, which was significantly higher than that of CD patients (P <0.05). Abdominal mass, abdominal lymph node enlargement and peritoneal effusion were more common in patients with PIL (P <0.05). A total of 69 patients with CD and 20 patients with PIL underwent gastrointestinal angiography, which showed filling defects, stiff wall, Nesting more than CD (P <0.05). A total of 67 CD cases and 18 PIL patients underwent endoscopic examination. PIL was diagnosed biopsied 61.1%, while 82.1% CD was non-specific inflammatory changes. The preoperative diagnosis rates of CD and PIL were 17.7% and 25.0% respectively. Conclusions CD and PIL are more difficult to diagnose and differentiate, with young and longer course of disease, perianal lesions and fistula formation. CD and PIL also support CD and disease recurrence easily. CDIL has short course of disease, single site disease and endoscopic biopsy rate Higher.