初发型与慢性复发型溃疡性结肠炎患者临床特点及诊疗比较分析  

Comparative analysis of clinical features,diagnosis and treatment of primary and chronic recurrent ulcerative colitis patients

作　　者：王华烨 罗和生[1] WANG Huaye;LUO Hesheng(Department of Gastroenterology,Renmin Hospital of Wuhan University,Wuhan 430060,China)

机构地区：[1]武汉大学人民医院消化内科,湖北武汉430060

出　　处：《胃肠病学和肝病学杂志》2020年第9期1003-1007,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：目的探讨初发型与慢性复发型溃疡性结肠炎(ulcerative colitis,UC)患者在发病危险因素、临床表现、疾病严重程度、实验室指标、内镜特点、病理特征、诱导缓解方法等方面的差异。方法收集2017年1月1日至2019年11月1日于武汉大学人民医院住院的137例UC患者的相关病例资料、辅助检查结果及药物治疗方法;依据患者既往史分为初发型组和慢性复发型组,对相关数据整理后采用SPSS 23.0统计软件进行统计学分析。结果初发型组61例,慢性复发型组76例;慢性复发型组饮酒史比率(28.9%)高于初发型组患者(13.1%)(P<0.05),在诱发因素比率上慢性复发型组比率(35.5%)也高于初发型(16.4%)(P<0.05);具体诱发原因中以停药(27.0%)、不洁饮食(16.2%)、刺激饮食(10.8%)为主;初发型组腹泻比率(60.7%)高于慢性复发型组(43.4%)(P<0.05);病变范围上慢性复发型组E1、E2比率(47.4%)高于初发型组(26.2%),E3比率(52.6%)低于初发型组(73.8%)(P<0.05);病理表现上初发型组隐窝脓肿、腺体萎缩比率(66.7%)高于慢性复发型组(39.4%)(P<0.05);药物治疗方面初发型组单用水杨酸制剂比率(73.8%)明显高于慢性复发型组(40.8%)(P<0.001),全身应用类固醇激素比率(21.3%)明显低于慢性复发型组(51.3%)(P<0.001)。两组在性别、年龄、腹痛、血便、体质量减轻、发热、疾病严重程度和病情活动度、WBC、Hb、CRP、ESR、贫血程度等实验室指标及内镜表现和免疫抑制应用上比较,差异均无统计学意义(P>0.05)。结论慢性复发型UC患者相对于初发型UC患者往往发病具有明显诱发原因,饮酒既可能是其危险因素,也可是诱发原因之一;初发型患者腹泻比率高于慢性复发型患者,可能与这里患者病变范围多位于降结肠以上部分相关;初发型患者隐窝脓肿比率较高,提示病情进展变化可能。慢性复发型患者类固醇激素应用明显高于初发型患者,对于复发型患者药物诱导缓�Objective To investigate the differences in the risk factors,clinical manifestations,disease severity,laboratory indicators,endoscopic features,pathological features,induction remission methods,etc.of patients with primary and chronic recurrent ulcerative colitis(UC)patients.Methods The relevant case data,auxiliary examination results,and drug treatment methods of 137 UC patients admitted to Renmin Hospital of Wuhan University from Jan.1st 2017 to Oct.1st 2019 were collected.According to the patient’s previous history,they were divided into the primary group and the chronic recurrent group.SPSS 23.0 was used after collating the relevant data for statistical analysis.Results There were 61 cases in the primary group and 76 cases in the chronic recurrent group.The rate of drinking history in the chronic recurrent group(28.9%)was higher than that in the primary group(13.1%)(P<0.05).Chronic recurrent group rate(35.5%)was also higher in predisposing factors than that in the primary group(16.4%)(P<0.05).The specific causes were mainly drug withdrawal(27.0%),unclean diet(16.2%),and stimulating diet(10.8%).The diarrhea rate(60.7%)in the primary group was higher than that in the chronic recurrent group(43.4%)(P<0.05).The ratio of E1 and E2(47.4%)in the chronic recurrent group in the lesion range was higher than that in the primary group(26.2%)and the E3 ratio(52.6%)was lower than that in the primary group(73.8%)(P<0.05).Pathologically,the ratio of crypt abscess and glandular atrophy(66.7%)in the primary group was higher than that in the chronic recurrent group(39.4%)(P<0.05).In terms of drug treatment,the salicylic acid monotherapy ratio(73.8%)in the primary group was significantly higher than that in the chronic recurrent group(40.8%)(P<0.001),and the rate of systemic steroids(21.3%)was significantly lower than that in the chronic recurrent group(51.3%)(P<0.001).There were no statistical differences between the two groups in laboratory indicators such as gender,age,abdominal pain,bloody stools,weight loss,fever,disease

关 键 词：溃疡性结肠炎 临床类型 比较分析 

分 类 号：R574.62[医药卫生—消化系统]