老年人微观肠炎临床特点和美沙拉嗪短期治疗效果分析  

Clinical features of microscopic colitis in the elderly and short-term effect of mesalamine on microscopiccolitis

作　　者：张俊峰[1] 刘娜[1] 魏子白[1] 王少黎 

机构地区：[1]长治医学院附属和平医院内镜中心,046000 [2]老年科

出　　处：《中华老年医学杂志》2013年第7期748-750,共3页Chinese Journal of Geriatrics

摘　　要：目的研究老年人微观肠炎临床特点及美沙拉嗪短期治疗效果。方法选择2011年112月长治和平医院诊断为微观肠炎的老年患者116例，分析其临床表现、微观肠炎相关药物服用状况、病理分型及美沙拉嗪短期治疗效果。结果老年人微观肠炎占同期老年慢性腹泻患者27．6％，临床表现轻中度水样、黏液便，伴重度腹痛者仅占1．7％。胶原性肠炎与淋巴细胞肠炎型分别为31.9％与68．1％，约50．0％患者有服用微观肠炎相关药物史；美沙拉嗪治疗4周后，胶原性肠炎组有效率为64．9％，淋巴细胞肠炎组为84．8％，差异有统计学意义（X^2=5．929，P=0．015）；淋巴细胞肠炎组治疗有效率与病理缓解相关（X^2=5．896，P=0．015）；停药8周后，两组复发率分别为45．8％与34．3％（X^2=0．999，P=0．317）。结论微观肠炎可能是老年慢性腹泻患者主要病因之一，美沙拉嗪治疗老年微观肠炎患者近期疗效较好，但长期维持治疗仍需进一步观察。Objective To investigate clinical features of microscopic colitis （MC） in the elderly and short-term effect of mesalamine on MC. Methods Totally 116 elderly patients with MC in our hospital were recruited from January 2011 to December 2011. Clinical manifestations, use of MC related drugs （MCRDs）, pathological classifications and short-term effect of mesalazine were collected and analyzed. Results MC patients accounted for 27.6% in elderly patients with chronic diarrhea, who presented with mild to middle watery or mucous stool, and only 1.7% of MC patients accompanied with severe stomach pain. Collagenous colitis （CC） and lymphocytic enteritis （LC） accounted for 31.9% and 68.1%, respectively in MC patients and 50% of them had MCRDs taking history. There was a significant difference in short-term effective rate between CC group and LC group at 4 weeks aftermesalazine treatment （64.9% vs. 84.8%0,）X^2=5.929,P=0.015）. The effective rate was significantly related with the relief of pathology in LC group （X^2=5. 896,P=0. 015）. The relapse rate had no significant difference between CC group and LC group at 8 weeks after withdrawal of mesalazine treatment （45.8% vs. 34.3%, P=0. 317）. Conclusions MC may be one of the main reasons leading to chronic diarrhea in the elderly. Mesalazine has a better effect for the short term treatment of MC in the elderly, but the long term maintenance therapy still needs further study.

关 键 词：结肠炎 显微镜下 氨水杨酸 

分 类 号：R574[医药卫生—消化系统]