全结肠型与远端型溃疡性结肠炎的临床病理和内镜特点分析  

Analysis of the clinical, pathological and endoscopic features of patients with ulcerative pancolitis and distal colitis

作　　者：钟英强[1] 黄花荣[2] 朱兆华[1] 幸连春[3] 

机构地区：[1]中山大学附属第二医院消化内科,广州510120 [2]中山大学附属第二医院儿科,广州510120 [3]中山大学附属第二医院病理科,广州510120

出　　处：《中华消化杂志》2006年第4期232-235,共4页Chinese Journal of Digestion

摘　　要：目的探讨全结肠型(PUC)和远端型溃疡性结肠炎(DUC)的临床病理和内镜特点及其区别。方法采用病例对照研究方法分析PUC 52例和DUC 97例的临床病理和内镜资料。结果 PUC 的血便明显者(90．38％)较DUC(71．13％)多(P<0．05),每日血便次数(6．86±4．52)亦较DUC(4．00 ±2．52)多(P<0．01),临床活动指数(AI)(201．03±35．73)明显高于DUC(157．52±37．73)(P<0．01), 临床分级以Ⅱ、Ⅲ级为主,其中Ⅲ级构成比明显高于DUC(P<0．05),而DUC以Ⅱ级为主(P<0．05)。 PUC的临床分型中初发型和慢性持续型较DUC多(P<0．05),而慢性复发型较DUC少(P<0．05),临床分度以中重度为主(P<0．05),而DUC以轻中度为主(P<0．05)。PUC合并肝功能损害(23．08％)明显多于DUC(7．22％)(P<0．05),合并不典型增生和癌变明显多于DUC(P<0．05),合并息肉发生率两组差异无统计学意义(P>0．05)。PUC的内镜分级以Ⅳ级较DUC多,而I、Ⅱ级较DUC少(P< 0．05)。结论 PUC在临床病理和内镜特点均与DUC有明显区别,提示PUC在发病机制和病理生理方面与DUC可能有着一定差异,有待进一步研究。Objective To investigate the clinical, pathological and endoscopic features of patients with ulcerative pancolitis （PUC） and distal colitis （DUC） and their differentiations. Methods The clinical, pathological and endoscopic data of 52 patients with PUC and 97 patients with DUC were analyzed by case-control study. Results The incidence and the frequency of bloody stool in patients with PUCwere both higher than those in DUC （90.38% vs. 71.13%, P〈0.05; 6.86±4.52 vs. 4.00 ±2. 52, P〈0.01）. There was significant higher increase in clinical activity index （AI） in PUC compared with DUC （201.03±35.73 vs. 157.52±37.73, P〈0. 001）. The case with clinical grade Ⅱ and Ⅲ were predominant in PUC, and particularly, grade Ⅲ was more common than that in DUC （P〈0.05）, in which grade Ⅱ was predominant （P〈0.05）. In clinical classification, the initial attack type and chronic sustained type were more common, and chronic recurrent type was less seen in PUC compared with that in DUC （P〈0. 05）. In terms of clinical severity, the moderate and severe types of UC were predominant in PUC as compared with DUC, in which mild to moderate types were predominant （P〈0.05）. The rate of hepatic dysfunction, colon epithelial cell dysplasia and carcinogenesis in PUC were higher than that in DUC （P〈0. 05）, but there was no difference in rate of polyps between two groups （P〈0. 05）. The endoscopic grade Ⅳ was more and grade Ⅰ and Ⅱ were less seen in PUC than that in DUC （P〈0. 05）. Conclusions There are significant differences in the clinical, pathological and endoscopic features between PUC and DUC. This indicates that there may be distinct differences in the pathogenesis and pathophysiology between PUC and DUC.

关 键 词：溃疡性结肠炎 全结肠炎 远端结肠炎 内镜检查 病例对照研究 

分 类 号：R574.62[医药卫生—消化系统]