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结核性肠炎

Authors
Louis-Michel Wong Kee Song, MD, FRCP(C)
Norman E Marcon, MD, FRCP(C)
Section Editor
Stephen B Calderwood, MD
Deputy Editor
Elinor L Baron, MD, DTMH
Translators
欧阳钦, 主任医师，教授

引言

肺外结核病(tuberculosis, TB)累及约20%的免疫功能正常结核病例和约50%的人类免疫缺陷病毒(human immunodeficiency virus, HIV)阳性结核病例。结核性肠炎是肺外结核病的一种，可累及胃肠道任何部位。结核性肠炎占全世界结核病的1%-3%[1]，位居最常见肺外结核病类型中的第6位(排列于淋巴结核、泌尿生殖系结核、骨与关节结核、粟粒性结核和脑膜结核之后)[2]。在全球范围内，结核性肠炎的流行病学差异较大，部分受年龄、性别、社会经济因素、免疫状态和结核分枝杆菌基因型的影响[3]。像在巴基斯坦、土耳其和西非地区，年轻成人(主要是女性)最常受累，而来自中国、新加坡、印度和英国的研究报道的疾病发病率更低且男性患者与女性患者数量近似或男性患者更多[3]。

在抗结核治疗出现前，曾观察到55%-90%的活动性肺结核患者出现胃肠道受累，但自从抗结核治疗后，观察到约25%的病例出现胃肠道受累[4]。

与胃肠道结核病相关的问题将总结在此；与肺外结核病其他方面相关的问题将单独讨论。 (参见“肺外结核和粟粒性结核的临床表现、诊断及治疗”)

发病机制

结核性肠炎的发病机制已被归因于以下4种[5-7]：

●吞咽受感染的痰液

            

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Literature review current through: 2017-06 . | This topic last updated: 2016-06-17.
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