294例炎症性肠病临床特点及随访分析  

Retrospective analysis and follow-up on 294 cases of inflammatory bowel disease

作　　者：黄娟[1] 魏艳玲[1] 王军[1] 兰春慧[1] 秦谦[1] 龚豪[1] 颜綦先[1] 崔红利[1] 沈小春[1] 杨均[1] 陈东风[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所消化内科,重庆400042

出　　处：《第三军医大学学报》2016年第8期835-839,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金青年基金(81500408);第三军医大学大坪医院野战外科研究所临床科研基金(2014YLC05)~~

摘　　要：目的总结我院10年间炎症性肠病(inflammatory bowel disease,IBD)住院患者的流行病学特点、临床表现以及疾病预后情况。方法收集我院10年间294例住院IBD患者的临床资料,并电话随访其上皮内瘤变、手术及死亡率,分析溃疡性结肠炎(ulcerative colitis,UC)及克罗恩病(Crohn’s disease,CD)患者流行病学、临床表现及疾病预后的特点。结果 10年间我院IBD患者住院人数有逐年上升的趋势,两者均好发于青壮年人群,发病无明显性别倾向性(P>0.05);临床及肠镜表现上,UC以腹泻、血便、里急后重、黏膜充血水肿、糜烂表现为主,CD则主要表现为腹部包块、息肉样病变、肠管僵硬/狭窄及铺路石样结节,差异具有统计学意义(P<0.05);UC手术肠管切除率明显低于CD,差异具有统计学意义(P<0.05),但两者在低级别上皮内瘤变率及死亡率上相似,差异无统计学意义(P>0.05)。结论 UC及CD均好发于青壮年人群,发病无明显性别倾向性;临床上UC主要以肠道粘膜受损为突出表现,而CD则以肠道增殖性病损表现为主;两者在低级别上皮内瘤变率及死亡率上相似,但UC手术肠管切除率明显低于CD。Objective To explore the epidemiological and clinical characteristics and prognosis of patients with inflammatory bowel disease（ IBD）. Methods A total of 294 hospitalized IBD patients admitted in our hospital from 2005 to 2014 were enrolled in this study for the clinical data and the prognosis during the follow-up including the rate of intraepithelial neoplasia,surgery and death. The clinical,epidemiological and prognostic characteristics were compared between ulcerative colitis（ UC） and Crohn ＇s disease（ CD）.Results The hospitalized patients with IBD were growing during 2005- 2014. UC and CD mainly occurred in young adults and had equal gender distributions. UC mainly manifested as diarrhea, bloody stool,tenesmus,mucosal hyperemia/edema and erosion in the aspect of clinical and endoscopic manifestations,while CD usually as abdominal mass,polyps,bowel stiff/narrow and cobblestone like nodules,with significant differences（ P〈0. 05）. In prognosis,the rates of intraepithelial neoplasia and death were resemble（ P〉0. 05）,but the colectomy rate of UC was significantly lower than that of CD（ P〈0. 05）. Conclusion UC and CD mainly occur in young adults and have equal gender distribution. UC usually shows intestinal mucosa damage while CD mostly shows intestinal proliferative lesion in the aspect of clinical and endoscopic manifestations. The colectomy rate of UC is significantly lower than that of CD,but the rates of intraepithelial neoplasia and death are resemble.

关 键 词：溃疡性结肠炎 克罗恩病 流行病学 

分 类 号：R195.4[医药卫生—卫生统计学] R574[医药卫生—卫生事业管理]