阑尾开口炎在远端溃疡性结肠炎的临床意义  

Clinical significance of appendiceal orifice inflammation in distal ulcerative colitis

作　　者：刘继喜[1] 宋振梅[1] 王晓娣[1] 赵洪川[1] 

机构地区：[1]中日友好医院消化内科,北京100029

出　　处：《胃肠病学和肝病学杂志》2013年第1期74-76,共3页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的研究阑尾开口炎(AOI)出现在远端溃疡性结肠炎(DUC)的临床意义。方法从我院炎症性肠病数据库中选择资料完整的DUC伴有AOI和不伴有AOI的患者。两组在病变程度、吸烟史、诊断时年龄、病程及初始治疗药物等进行配对。收集随访中的临床资料,并比较AOI在缓解期及活动期消失的比率。结果 23例患者符合诊断DUC伴AOI,病变位置以乙状结肠和降结肠为主。患者起始使用美沙拉嗪的途径分别为:口服(34.8%),栓剂(13%)、两者联合(52.2%)。随访时间平均为25个月,经使用氨基水杨酸治疗后大部分患者病情控制或缓解。只有2例患者病情加重,病变向近端发展。与31例对照组患者比较,两组在各个临床指标方面没有明显差异。缓解期有66.7%的AOI愈合,而活动期只有25%愈合(P=0.09)。结论阑尾开口炎可能是UC疾病活动的一个标志。作为一个亚组,DUC-AOI疾病预后较好,出现病变加重、需要免疫抑制剂及手术的可能性较低。Objective To evaluate the clinical significance of appendieeal orifice inflammation（AOI） in distal ulcerative colitis（DUC）. Methods Patients with DUC-AOI were selected from our inflammatory bowel disease （IBD） database. Variables of clinical features and therapeutic requirements during follow up were accurately collected and compared with control group of DUC without AOI matched with disease extent, smoking habit, and duration and age at diagnosis. The disappearance rate of AOI was compared between the patients in remission and in active stage. Results 23 DUC patients were found to have AOI, most of which with initial extent extending to the sigmoid and descending colon. All patients were initially treated with mesalazine orally （34. 8% ）, topically （ 13% ）, or in combination （52.2%）. After a follow-up period averaging 25 months （range： 12～49 months）, most DUC-AOI patients were successfully managed with oral and/or topical aminosalicylates. Only 2 patients of them progressed proximally. Compared with 31 controls, no differences in clinical outcomes or therapeutic requirements were found. AOI disappeared in 66.7% of the 15 patients in remission, while only 25% in the patients still in active stage （P = 0.09）. Conclusion AOI is probably an endoscopic marker of active disease. Patients with DUC-AOI, as a subgroup, tend to present a mild course with low probability to develop proximal progression of disease extent or to require immunosuppressive therapy or colectomy.

关 键 词：溃疡性结肠炎 阑尾开口炎 病例对照 

分 类 号：R574.62[医药卫生—消化系统]