摘要目的 评价炎症性肠病包括溃疡性结肠炎(UC)和克罗恩病(CD)内镜分级和评分标准的一致性.方法 利用Medline和中国生物医学数据库搜索炎症性肠病分级和评分系统,设计准备标准化表格.在2006年6月至2007年2月期间,纳入进行肠镜检查的80例UC患者和31例CD患者,由2位医师按各种评价体系独立评价,数据处理使用SPSS 13.0.结果 用国内标准、Truelove标准、Baron标准、修正的Baron标准、Jeroen标准、Azzolini标准6种UC评价体系和国内标准、CD内镜严重程度指数、简化CD内镜评分3种CD评价体系进行评价.在UC和CD总体一致性评价体系中,Kendall和谐系数分别为0.71(P<0.01)和0.34(P<0.01),即UC的总体一致性较好而CD的较差.UC的每两种评分体系间无统计学差异;但是国内CD内镜分级标准和CD内镜严重程度指数的Spearman相关系数仅0.32(P=0.08).Kruskal Wallis频数检验表明UC内镜下疾病严重程度评价标准之间具有统计学差异(P<0.01).结论 UC的内镜分级和评分体系具有令人满意的一致性,但Jeroen标准倾向于UC重度分级,修正的Baron分级倾向于轻度.而国内CD内镜分级标准尚待改进.

abstractsObjective To assess the agreement of different endoscopy grading or scoring systems for inflammatory bowel diseases(IBD)including ulcerative colitis(UC)and Crohn's disease(CD).Methods A standardized table was prepared based on the searches for endoscopic grading or scoring systems on Medline and Chinese Biomedical Database,the data of 80 patients with UC and 31 with CD.who underwent colonoscopy in Shanghai Renji hospital from June 2006 to February 2007,were evaluated with each system by two physicians independently.Data were analyzed with SPSS 13.0.Results Six endoscopic grading and scoring systems of UC and three of CD were included for evaluation.For the systems of UC and CD,Kendall's coefficients of concordance were 0.71(P<0.01)and 0.34(P<0.01),respectively.There was no significant differenee between every two systems for UC.Nonetheless.Spearman's correlation coefficient between Chinese Grading System of Crohn's Disease(CGSCD)and Crohn's Disease Endoscopic Index of Severity(CDEIS)was 0.32(P=0.08).Significant differences in frequencies were detected in endoscopic systems for UC by Kruskal Wallis test(P<0.01).Conclusion There is satisfactory concordance among the endoscopic grading and scoring systems of UC,while CGSCD needs further improvement.Furthermore,Jeroen elassifieation inclines to severe category,while modified Baron scale tends to be a mild one.