炎症性肠病合并自身免疫病临床特征及药物治疗方案研究  

Clinical characteristics and drug regimen of inflammatory bowel disease complicated with autoimmune diseases

作　　者：谢巧玉[1] 林霖[1] 

机构地区：[1]广东省梅州市人民医院消化科,514031

出　　处：《中国现代医药杂志》2018年第1期30-34,共5页Modern Medicine Journal of China

摘　　要：目的分析炎症性肠病(IBD)合并自身免疫病(AD)患者临床特征,探讨药物治疗方案差异。方法选取2012年1月~2017年5月我院收治的IBD合并AD患者62例及同期单纯IBD患者84例,回顾性分析其临床资料,按照IBD病种及是否合并AD分成CD+AD组22例,CD组35例,UC+AD组40例,UC组49例,比较分析各组患者疾病严重程度、肠外表现、病变部位及治疗方案。结果 4组间性别、年龄、病变范围差异无统计学意义(P>0.05),CD+AD组病程长于CD组,UC+AD组病程长于UC组,差异有统计学意义(P<0.05);CD+AD组轻度活动期患者比例低于CD组,重度活动期患者比例高于CD组,差异有统计学意义(P<0.05);UC+AD组轻度患者比例低于UC组,重度患者比例高于UC组,差异有统计学意义(P<0.05);CD+AD组肠外表现发生率高于CD组,UC+AD组发生率高于UC组,差异均有统计学意义(P<0.05),其中关节炎发生率最高,其次为脂肪肝。治疗药物以氨基水杨酸制剂为主,合并自身免疫病者部分联合糖皮质激素、免疫制剂。常规治疗无效或病情十分严重者给予激素治疗,激素使用率IBD+AD组明显高于IBD组(P<0.05),IBD+AD组有8例使用氨基水杨酸制剂和糖皮质激素治疗效果不佳,改用激素+免疫抑制剂缓解。结论炎症性肠病合并自身免疫病患者临床表现多样,病情严重,早期内科药物治疗对于病情缓解有效。Objective To analyze the clinical characteristics of patients with inflammatory bowel disease（IBD） complicated with autoimmune diseases（AD）,and to explore the difference of drug treatment regimen. Methods 62 patients with IBD complicated with AD and 84 patients with IBD were enrolled in our hospital from Jan 2012 to May 2017. The clinical data were analyzed retrospectively. According to IBD disease and whether it was complicated with AD,the patients were divided into CD＋AD group（n=22）,CD group（n=35）,UC＋AD group（n=40） and UC group（n=49）.The severity of disease, parenteral manifestation, lesion site and treatment plan were compared and analyzed. Results There was no significant difference in sex, age and lesion range among the four groups（P 0.05）. The duration of CD＋AD was longer than that of CD group. The duration of UC＋AD was longer than that of UC group, the difference was statistically significant（P〈0.05）.The proportion of mild patients in UC＋AD group was lower than that in UC group, and the severity was higher than that in UC group, and the difference was statistically significant（P〈0.05）.The incidence of parenteral manifestation in CD＋AD group was higher than that in CD group and UC＋AD group was higher than that in UC group（P〈0.05）,and the incidence of arthritis was the highest, followed by fatty liver. The main theraputic drugs was aminosalicylic acid preparation, complicated with autoimmune disease in part with glucocorticoid, immunocompetent.The rate of hormone utilization in IBD＋AD group was significantly higher than that in IBD group（P〈0.05）.8 patients treated with aminosalicylic acid and glucocorticoid were not effective in the treatment of IBD＋AD group（P〈0.05）,switch to hormone and immunosuppressant remission. Conclusion The clinical manifestation of patients with inflammatory bowel disease complicated with autoimmune is serious,and the early medical treatment is effective for remission.

关 键 词：炎症性肠病 自身免疫病 临床特征 肠胃表现 

分 类 号：R574[医药卫生—消化系统] R593.2[医药卫生—内科学]