【超声指标在炎性肠病活动性评价中的应用体会】。

IF 0.3 4区医学 Q3 MEDICINE, GENERAL & INTERNAL

Terapevticheskii Arkhiv Pub Date : 2025-08-28 DOI:10.26442/00403660.2025.08.203303

D D Mukhametova, I M Minnemullin, O E Akchurina, A K Odintsova, D I Abdulganieva

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引用次数: 0

摘要

目的：探讨超声参数及指标对活动性炎症性肠病（IBD）的诊断价值。材料和方法：本研究纳入115例IBD患者，41例（36%）溃疡性结肠炎（UC）患者和74例（64%）克罗恩病（CD）患者。在S2N超声显像上对肠道进行经腹超声检查，肠壁厚度（BWT）为3mm。为了评估UC的活动，使用米兰超声标准（MUC）评分，并使用CD -国际肠超声节段活动评分（IBUS-SAS）。结果：活动期UC患者BWT （5.91 [4.87; 6.95] mm）大于缓解期患者（2.9 [2.6;3.1]mm; p = 0.003）。对于活动性UC诊断，BWT大于3 mm的敏感性（Se）为90.5%，特异性（Sp）为70.6%。加重期MUC（9[7.88; 11.8]）高于缓解期MUC （4.2 [3.64; 4.9]; p < 0.001）。在31例（89%）急性加重患者中，MUC高于6.2 (Se 88.9%, Sp 87.5%)， 34例（97%）的阈值高于5.18 （Se 96.3%, Sp 87.5%）。活动性CD患者BWT （4.9 [3.8; 6.6] mm）大于缓解期患者（3.18 [2.6;3.5];p = 0.0001）， Se为87.0%，Sp为71.4%。活动性CD患者IBUS-SAS评分46.8[27；71.5]高于缓解期患者（12.6 [11.2;30.2];p = 0.001）。当阈值为37.5时，IBUS-SAS的Se值为92.6%，Sp值为61.5%；当阈值为45.2时，Se值为92.6%，Sp值为87.2%。结论：超声显像是评估IBD活动性的有效工具；MUC评分的阈值为5.18，IBUS-SAS评分的阈值为45.2，表明对区分加重和缓解有更好的诊断价值。

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[Experience in the application of ultrasound indices for assessing the activity of inflammatory bowel diseases].

Aim: To evaluate the diagnostic value of ultrasound (US) parameters and indices for assessing the active inflammatory bowel diseases (IBD).

Materials and methods: The study included 115 patients with IBD, 41 (36%) patients were with ulcerative colitis (UC) and 74 (64%) - with Crohn's disease (CD). Transabdominal US examination of the intestine was performed on Sonoscape S2N, with a bowel wall thickness (BWT) of 3 mm considered the norm. To assess activity in UC, the Milan Ultrasound Criteria (MUC) score was used, and in CD - International Bowel Ultrasound Segmental Activity Score (IBUS-SAS).

Results: In active UC BWT (5.91 [4.87; 6.95] mm) was greater than in remission (2.9 [2.6; 3.1] mm; p = 0.003). For active UC diagnosis BWT greater than 3 mm had sensitivity (Se) of 90.5% and specificity (Sp) of 70.6%. The MUC in exacerbation (9 [7.88; 11.8]) was higher than in remission (4.2 [3.64; 4.9]; p < 0.001). In 31 (89%) patients in exacerbation, the MUC was higher than 6.2 (Se 88.9%, Sp 87.5%), and in 34 (97%) at a threshold of 5.18 (Se 96.3%, Sp 87.5%). In active CD, BWT (4.9 [3.8; 6.6] mm) was greater than in remission (3.18 [2.6; 3.5]; p = 0.0001), with Se 87.0%, Sp 71.4%. The IBUS-SAS in active CD (46.8 [27; 71.5]) was higher than the remission (12.6 [11.2; 30.2]; p = 0.001). At a threshold of 37.5, the IBUS-SAS had Se 92.6%, Sp 61.5%, and at 45.2, Se 92.6%, Sp 87.2%.

Conclusion: US imaging is a useful and effective tool for assessing IBD activity; a threshold value of the MUC score of 5.18 and IBUS-SAS of 45.2 suggests better diagnostic value for differentiating between exacerbation and remission.

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来源期刊

Terapevticheskii Arkhiv 医学-医学：内科

CiteScore

1.40

自引率

33.30%

发文量

171

审稿时长

3-8 weeks

期刊介绍： Терапевтический архив The journal was founded by the prominent Russian therapists M.P. Konchalovsky and G.F. Lang in 1923. Then its editors-in-chief were Professors V.N. Vinogradov and A.G. Gukasyan. Since 1972, E.I. Chazov, Academician of the Russian Academy of Sciences, has been heading the editorial board of the journal. Over 90 years, there have been more than 1000 issues where the authors and editorial staff have done their best for readers to keep abreast of current advances in medical science and practice and for physicians to master the advanced principles of recognition and treatment of a wide spectrum of visceral diseases. The papers published in the journal (editorials, original articles, lectures, reviews, etc.) cover both current scientific achievements and practical experience in diagnosing, treating, and preventing visceral diseases. The authors of publications are not only Russian, but also foreign scientists and physicians. All papers are peer-reviewed by highly qualified Russian specialists. The journal is published monthly. Traditionally, each issue has predominantly certain thematic areas covering individual therapy specializations. Every year, one of the issues is devoted to related problems in practical medicine (allergology and immunology, neurology and psychiatry, obstetrics, oncology, etc.). This all draws the attention of the reading public to the journal. The journal is indexed in RSCI (Russian Science Citation Index), PubMed/Medline, Index Medicus, Scopus/EMBASE, Web of Science Core Collection (Science Citation Index Expanded), Web of Science (Russian Science Citation Index - RSCI, Current Contents Connect, BIOSIS Previews), Google Scholar, Ulrich''s Periodicals Directory. The journal is included in the list of periodicals recommended by the Higher Attestation Committee for publishing the papers containing the basic materials of doctoral and candidate dissertations. By the decision of the Presidium of the Russian Academy of Medical Sciences, the “Therapevticheskiy Arkhiv” was awarded the Botkin medal. It was admitted to the European Association of Sciences Editors (EASE). The journal was honored with the Golden Press Fund decoration at the 13th International Press Professional Exhibition.