2000～2014年我院炎症性肠病发病趋势及临床特征  

Incidence trend and clinical characteristics of inflammatory bowel diseases from 2000 to 2014 in our hospital

作　　者：阮水良[1] 沈海燕[1] 陆其明[1] 杨志宏[1] 罗鼎天[1] 

机构地区：[1]嘉兴学院附属第二医院消化内科,浙江嘉兴314000

出　　处：《中国医药导报》2016年第22期40-43,共4页China Medical Herald

基　　金：浙江省嘉兴市科学技术局科技研究计划资助项目(2012AY1071-1)

摘　　要：目的了解2000～2014年嘉兴学院附属第二医院（以下简称“我院”）炎症性肠病的发病趋势。方法通过我院病历数据库，检索主要诊断为溃疡性结肠炎、克罗恩病或克隆病的住院病例，出院时间为2000年1月1日～2014年12月31日。同于内镜中心数据库检索诊断为溃疡性结肠炎、克罗恩病或克隆病的结肠镜检查患者，检查时间为2004年1月1日～2014年12月31日。观察炎症性肠病流行病学特征、内镜检出率以及临床特征。结果近15年间溃疡性结肠炎、克罗恩病住院患者占全院住院人数比例逐年增加（χ^2=41．873，P=-0．000；χ^2=77．764，P=0．000），由2000年的0．04％、0．01％分别增加到2014年的0．20％、0．09％。溃疡性结肠炎、克罗恩病患者的平均年龄为（55．1±15.3）、（43．3±17．4）岁，男女比分别为1：1.09、1：0．65。溃疡性结肠炎、克罗恩病的内镜检出率由2004年的0．75％、0．17％分别增加到2014年的1．18％、0．46％，克罗恩病的检出率逐年增加（χ^=19．687，P=0．032）。溃疡性结肠炎的主要症状为腹痛、腹泻、便血，而克罗恩病主要症状为腹痛、腹泻、消瘦，肛瘘以及肠外表现多见；发病至确诊时间分别为（7．2±11．6）、（18．3±16．5）个月。溃疡性结肠炎患者肠镜下累及左半结肠、全结肠分别占34％、66％；克罗恩病患者回肠末端、回肠末端＋结肠、小肠、全消化道病变分别占39％、12％、21％、28％，伴肛瘘者为28．6％。内镜、小肠CT等影像学检查是目前诊断炎症性肠病的主要方法。克罗恩病疗效仍不理想。结论炎症性肠病发病率逐年增加，内镜医师应与病理学、影像学医师合作提高对此病的诊治水平，减少误诊及漏诊，并提高炎症性肠病的疗效。Objective To explore the incidence trend of inflammatory bowel diseases （IBD） from 2000 to 2014 in the Second Affiliated Hospital of Jiaxing College （＂our hospital＂ for short）. Methods Clinical data of inpatients diagnosed as ulcerative colitis （UC） or Crohn＇s disease （CD） from January 1, 2000 to December 31, 2014 in our hospital were analyzed retrospectively. Endoscopy center database were retrieved during the period of January 1, 2004 to December 31, 2014. Epidemiology, endoscopic detection rate and clinical features of IBD were observed. Results The proportions of annual admissions of UC and CD to total admissions increased year by year in recent 15 years （χ^2=41.873, P=0.000; χ^2=77.764, P=0.000）, from 0.04% and 0.01% in 2000 to 0.20% and 0.09% in 2014 respectively. The average ages of UC and CD were （55.1±15.3） and （43.3±17.4） years, and the sex ratios were 1：1.09 and 1：0.65 respectively. Detection rates of UC and CD by endoscopy rosed from 0.75% and 0.17% in 2004 to 1.18% and 0.46% in 2014 respectively. Detection rates of CD increased year by year （χ^2=19.687, P=0.032）. The main symptoms of UC were abdominal pain, diarrhea and hematochezia. While clinical symptoms of CD focused on abdominal pain, diarrhea, emaciation, anal fistula and parenteral performance. Time from onset to confirmed diagnosis of UC and CD were （7.2±11.6） and （18.3±16.5） months respectively. Colonoscopy showed that pathological changes of UC were focused on left colon and total colon, accounting for 34% and 66% respectively. Lesions of CD were located in terminal ileum （39%）, terminal ileum＋colon （12%）, small intestine （21%） and the whole digestive tract （28%）, 28.6% accompanied with anal fistula. Endoscopy and small bowel CT were the main methods in diagnosis of IBD. Curative effect of CD was not so perfect. Conclusion Incidence of IBD is increasing year by year. Endoscopic physicians should cooperate with pathologist and radiologist so as to improve the diagnosi

关 键 词：炎症性肠病 溃疡性结肠炎 克罗恩病 发病率 统计 

分 类 号：R574[医药卫生—消化系统]