Study On The Early Differential Diagnosis Of Intestinal Tuberculosis And Crohn’s Disease

Objective:To investigate the first-onset and accompanying symptoms,laboratory indicators,imaging examination,endoscopy and pathological characteristics of Crohn’s disease and intestinal tuberculosis,and to screen out indicators that are valuable for the early differential diagnosis of the two.Methods:Collected 93 patients with Crohn’s disease(CD)and 38 patients with intestinal tuberculosis(ITB)who were admitted to the Second Affiliated Hospital of Anhui Medical University from January 2015 to May 2020.The initial clinical visit data,and through the collation,statistics and retrospective analysis of its clinical manifestations,laboratory indicators,imaging examination,endoscopy and pathological examination related indicators,using SPSS technology,using t-test method and chi-square test method to screen out Valuable clinical indicators for the early differential diagnosis of intestinal tuberculosis(ITB)and Crohn’s disease(CD).Results:1.Clinical manifestations:The average age of onset of CD patients is younger than that of ITB patients,and those with low fever as the first symptom are more likely to be seen in ITB patients,and the difference is statistically significant(P<0.05).In addition,most ITB patients have pulmonary disease,and CD patients often have no related pulmonary manifestations,the difference is statistically significant(P<0.05).2.Laboratory indicators:CD patients are more likely to have HB decrease and CRP increase than ITB patients,and the difference is statistically significant(P<0.05).However,elevated blood mononuclear cells,T-SPOT positive,PPD test positive,and sputum looking for acid-fast bacilli were more likely to be seen in ITB patients,and the difference was statistically significant(P<0.05).3.Imaging examination:There is no significant difference in imaging performance of ITB and CD in conventional abdominal CT examination,and there is no special reference value for the differential diagnosis of the two.CTE examination of the small intestine showed that CD disease changes were likely to occur in the ileocecal area,terminal ileum,small intestine and right colon,and the difference was statistically significant(P<0.05).CD is more likely to have local thickening of the tube wall,segmental thickening,combined with the formation of retroperitoneal enlarged lymph nodes and other imaging findings,the difference was statistically significant(P<0.05).4.Colonoscopy:Compared with ITB group,patients in CD group showed more lesions in the right colon and had segmental changes,and most of them showed inflammation under endoscopy,the difference was statistically significant(P<0.05)5.Pathological manifestations:CD is easier to detect lymphoid follicles,lymphoid tissue hyperplasia,and lymphocyte aggregation than ITB patients’ biopsy.Chronic mucosal inflammation is more common than ITB patients;the detection of multi-megakaryocytes is more valuable for the diagnosis of ITB.Caseous granulomas are more common in ITB,non-caseating granulomas are more common in CD,and the difference is statistically significant(P<0.05).Conclusion:CD and ITB have extremely high clinical similarities,and early differential diagnosis is difficult.It is necessary to comprehensively improve related examinations to better perform early identification and diagnosis.