缺血性结肠炎青、中老年患者临床特征的比较  

Comparison of clinical characteristics of ischemic colitis between young and elderly patients

作　　者：斯锞[1] 杨杰[1] 廖文[1] 

机构地区：[1]成都市第一人民医院消化内科,四川省成都市610014

出　　处：《世界华人消化杂志》2014年第34期5376-5380,共5页World Chinese Journal of Digestology

摘　　要：目的:了解缺血性结肠炎(ischemic colitis,IC)在不同年龄段的临床特征.方法:纳入近6年住院IC患者68例,总结其临床表现、肠镜下特征、基础疾病或易患因素及治疗转归,并将青(≤45岁)、中老年(>45岁)两组患者进行比较分析.结果:青、中老年组分别13例、55例.两组临床表现差异无统计学意义(P>0.05).肠镜下特征:两组直肠、乙状结肠、乙状结肠、降结肠同时受累率差异无统计学意义(P>0.05),中老年组降结肠、脾曲及脾曲近端受累率明显高于青年组(P<0.05);中老年组病变累及肠壁全周、溃疡及假瘤征出现率明显高于青年组(P<0.05).中老年组83.6%伴有与血管/血流动力学异常相关基础疾病,明显高于青年组15.4%(P<0.01),青年组口服避孕药者比例明显高于中老年组(38.5%vs 0.0%,P<0.01).66例(97.1%)于治疗后24-72 h内症状明显减轻,青、中老年组24 h内腹痛消失率分别为69.2%、32.7%,便血停止率分别为76.9%、40.0%,差异有统计学意义(P<0.05).2 wk后青年组黏膜痊愈率100.0%,明显高于中老年组67.3%(P<0.05).结论:青、中老年IC患者在临床表现方面无明显差别,而青年组在肠道病变程度、受累肠段范围方面轻于中老年组,治疗后症状缓解较快青年组女性口服避孕药可能为一重要易患因素,而中老年组以血管/血流动力学异常为主.AIM： To analyze the clinical characteristics of ischemic colitis（IC） in different age groups. METHODS： Sixty-eight inpatients diagnosed with IC over the past 6 years were collected. The clinical manifestations, findings on diagnostic colonoscopy, associated medical problems or risk factors, and clinical outcome were reviewed. A comparison between two age groups（≤ 45 and 〉 45 years old） was conducted. RESULTS： There were 13 young and 55 elderly patients. No significant difference was found in clinical manifestations between the two groups（P 〉 0.05）. For findings on diagnostic colonoscopy, there were no significant differences in the rates of affected rectum, sigmoid colon, or sigmoid plus descending（P 〉 0.05）, while the rates of affected descending colon, splenic flexure and proximal spleen curve area, and whole intestinal wall, as well as ulcer and pseudotumor appearance in the elderly group were significantly higher than those in the young group（P 〈 0.05）. In the elderly group, the rate of basic diseases associated with vascular/hemodynamic abnormalities was significantly higher than that in the young group（83.6% vs 15.4%, P 〈 0.01）, while the rate of taking oral-contraceptives was significantly higher in the young group（38.5% vs 0%, P 〈 0.01）. There were 66 patients whose clinical symptoms were relieved in 24-72 h after treatment. The relief rates of abdominal pain（69.2% vs 32.7%） and bleeding（76.9% vs 40.0%） in 24 h were significantly higher in the young group（P 〈 0.05）. The mucosal healing rate in 2 wk in the young group was higher than that in the elderly group（100% vs 67.3%, P 〈 0.05）. CONCLUSION： In IC patients, there is no significant difference in clinical manifestations between young and elderly patients. For younger population, the extent and severity of the involved colon are lower and it took shorter period of time for symptom relief with treatment. Oral contraceptives and vascular/hemodynamic abnormalities may be important risk fa

关 键 词：缺血性结肠炎 青年 中老年 临床特征 

分 类 号：R574.62[医药卫生—消化系统]