Crohn病におけるカプセル内視鏡の役割―小腸X線造影とLewis scoreを用いた検討

Role of Capsule Endoscopy in the Management of Patients with Crohn's Disease

要旨　Crohn病（CD）にカプセル内視鏡（CE）を施行した37例について検討を行った．小腸X線造影との比較では検討所見すべてにおいてCEが有意に多くの病変を描出していた．また，Lewis score（LS）とCDAI，LSとCRPに有意な正の相関が認められた．一方，CDAI 150未満の症例の47.4％に，LS上軽度の内視鏡的活動性が認められた．検討結果より，CDの治療目標である粘膜治癒の確認には内視鏡観察が必要であり，将来的にCEはCDの活動性の評価に広く用いられると考えられた．また，現状での活動性の評価には，それぞれの検査機器の利点，欠点を理解し，相補的に用いることが重要である．

　37 CD（Crohn's disease）cases on which CE（capsule endoscopy）was performed were analyzed. CE detected more abnormal lesions compared with double contrast enteroclysis. Significant positive correlations were shown in LS（Lewis score）and CDAI（C-reactive protein）, LS and CRP（Crohn's disease activity index）. On the other hand, mild activity was shown endoscopically in 47.4％ of the clinical remission cases（CDAI less than 150）. We conclude that it is necessary to perform endoscopic observation to check whether or not mucosal healing has been achieved. In the future, CE will be regarded as the first line of investigation when examining intestinal mucosa of CD patients. But at this time, while understanding the advantages and the faults of each device, it is important to use them complementary to diagnose disease activity of CD patients.