胃と腸41巻12号

2006年11月発行

今月の主題 小腸疾患診療の新たな展開

主題

非特異性多発性小腸潰瘍症の小腸内視鏡所見―非ステロイド性抗炎症剤起因性小腸潰瘍症との比較

著者： 松本主之¹ 中村昌太郎¹ 江崎幹宏¹ 矢田親一朗¹ 城由起彦¹ 古賀秀樹¹ 望月祐一² 廣田千治² 中島穣² 工藤哲司¹ 河内修司¹ 八尾隆史³ 飯田三雄¹

所属機関： ¹九州大学大学院医学研究院病態機能内科学 ²新日本製鐵八幡記念病院内科 ³九州大学大学院医学研究院形態機能病理

ページ範囲：P.1637 - P.1648

文献概要

要旨　非特異性多発性小腸潰瘍症（CNSU）とNSAIDs起因性小腸潰瘍症（NSAIDs腸症）各6例の臨床像と小腸内視鏡所見を比較した．CNSUは診断時年齢が低く女性が多い傾向にあったが有意差はなかった．易疲労と腹痛，貧血，低蛋白血症，軽微な炎症所見が両群に共通した臨床像で，ヘモグロビン値は鉄剤を投与されていたCNSUで高かった．単発ないし多発性の全周性狭窄をCNSUの6例（100％）とNSAIDs腸症の3例（50％）に認め，狭窄部の開放性潰瘍は前者の5例と後者の1例にみられた．一方，辺縁明瞭な浅い非狭窄性輪状潰瘍はCNSUの3例（50％）とNSAIDs腸症の4例（67％）にみられ，前者全例と後者の1例では開放性であった．NSAIDs腸症2例に小潰瘍を，CNSUの3例に縦走・斜走潰瘍を認めた．以上より，CNSUとNSAIDs腸症の臨床像は類似するが，腸病変の内視鏡像は異なり前者は慢性開放性潰瘍を，後者は治癒傾向の強い潰瘍を特徴とすると考えた．

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