青海地区478例炎症性肠病临床特征研究分析  

Clinical characteristics of 478 cases of inflammatory bowel disease in Qinghai region

作　　者：安琪 王学红 陶嘉楠 周洪文 姜国民 王建全 莫泽功 马雪芹 胡心悦 李苏华 AN Qi;WANG Xuehong;TAO Jia′nan;ZHOU Hongwen;JIANG Guomin;WANG Jianquan;MO Zegong;MA Xueqin;HU Xinyue;LI Suhua(Department of Gastroenterology,Affiliated Hospital of Qinghai University,Xining 810001;Department of Gastroenterology,Qinghai Provincial People′s Hospital;Department of Gastroenterology,Xining First People′s Hospital;Department of Gastroenterology,Xining Second People′s Hospital;Department of Gastroenterology,Xining Third People′s Hospital;Department of Gastroenterology,Qinghai Cardiovascular and Cerebrovascular Disease Specialized Hospital;Qinghai University School of Medicine,China)

机构地区：[1]青海大学附属医院消化内科,青海西宁810001 [2]青海省人民医院消化内科 [3]西宁市第一人民医院消化内科 [4]西宁市第二人民医院消化内科 [5]西宁市第三人民医院消化内科 [6]青海省心脑血管病专科医院消化内科 [7]青海大学医学院

出　　处：《胃肠病学和肝病学杂志》2024年第9期1149-1154,共6页Chinese Journal of Gastroenterology and Hepatology

基　　金：青海省“昆仑英才·高端创新创业人才”计划[青人才字(2020)18号]。

摘　　要：目的对青海地区的炎症性肠病(inflammatory bowel diseases,IBD)患者临床资料和一般特点进行研究,提高该地区基层医疗机构对IBD的诊疗水平,提高该地区医疗机构对IBD确诊人群的动态监测与随访意识,加强规范治疗,提高本地区人群的疾病预防意识。方法回顾性分析2016年1月至2022年7月青海大学附属医院、青海省人民医院、西宁市第一人民医院、西宁市第二人民医院、西宁市第三人民医院确诊溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD)患者共478例,UC患者366例(76.57%),CD患者112例(23.43%)。结果两种疾病发病率具有性别差异(UC患者女性222例,CD患者女性39例)(P<0.05),CD患者的年龄比UC患者小(P<0.05),UC病变以全结肠受累为主(49.45%),疾病严重程度以轻度为主(55.74%),CD患者以回结肠为主(75.00%),中度居多(65.18%)。UC患者以慢性复发型为主(59.29%),CD患者以狭窄型为主(65.18%)。CD(20.77%)与UC(47.32%)肠外表现发生率差异有统计学意义(P<0.05),CD患者营养不良发生率(45.54%)高于UC患者(15.58%)(P<0.05)。CD的腹部手术率(13.39%)及阑尾切除率(26.79%)明显高于UC患者(P<0.05),CD对于生物制剂或免疫抑制剂的使用率(34.82%)也高于UC患者(6.56%)(P<0.05)。两种疾病患者,在C反应蛋白、Fe、总蛋白、白蛋白、Na^(+)、Ca^(2+)、K^(+)、血沉指标上在不同严重程度组间比较,差异均有统计学意义(P<0.05)。在UC组中,血红蛋白水平在轻度与中重度之间差异无统计学意义(P>0.05),CD组中有明显差异(P<0.05)。严重程度在不同民族间具有显著性差异(P<0.05)。结论青海地区IBD患者中UC较CD发病率高,以女性居多,但CD诊断年龄早于UC患者,且CD病情及严重程度等方面更为严重,接受生物制剂治疗人数更为普遍。疾病的严重程度与C反应蛋白、Fe、总蛋白、白蛋白、Na^(+)、Ca^(2+)、K^(+)指标具有相关性,不同民族间疾病的严重程度具有差异。Objective To study the clinical data and general characteristics of patients with inflammatory bowel diseases(IBD)in Qinghai region and improve the diagnosis and treatment level of IBD in primary medical institutions in this region,in order to improve the awareness of dynamic monitoring and follow-up of patients diagnosed with IBD and strengthen standardized treatment.To improve disease prevention awareness of the population in local area.Methods A total of 478 patients with ulcerative colitis(UC)and Crohn′s disease(CD),including 366 patients(76.57%)with UC and 112 patients(23.43%)with CD were collected from the Affiliated Hospital of Qinghai University,Qinghai provincial People′s Hospital,Xining First People′s Hospital,Xining Second People′s Hospital,Xining Third People′s Hospital from Jan.2016 to Jul.2022.Results There was a gender difference in the incidence of the two diseases(222 women with UC and 39 women with CD)(P<0.05).The mean age of CD was younger than that of UC(P<0.05).The majority of UC lesions were distant involvement of the whole colon(49.45%),and the severity of disease were mild(55.74%).The ileocolon was predominant(75.00%)and moderate(65.18%)in CD patients.The majority of UC patients were chronic recurrent type(59.29%),and the majority of CD patients were narrow type(65.18%).There was a difference in the incidence of parenteral manifestations between CD(20.77%)and UC(47.32%)(P<0.05).The incidence of malnutrition in CD patients(45.54%)was higher than that in UC patients(15.58%).The abdominal operation rate(13.39%)and appendectomy rate(26.79%)of CD were significantly higher than those of UC patients(P<0.05),and the use rate of CD for biologics(34.82%)was also higher than that of UC patients(6.56%)(P<0.05).Patients with the two diseases were compared in terms of severity.The test results showed that there were statistically significant differences in C-reactive protein,Fe,total protein,albumin,Na^(+),Ca^(2+),K^(+)and ESR with the severity(P<0.05).There was no significant difference in he

关 键 词：青海地区 炎症性肠病 溃疡性结肠炎 克罗恩病 不同民族 

分 类 号：R574.62[医药卫生—消化系统]