15例老年溃疡性结肠炎患者临床和内镜分析

Clinical and colonoscopic analysis of 15 cases of ulcerative colitis in the elderly

目的回顾性分析老年人群(≥60岁)溃疡性结肠炎(UC)临床及内镜特点。方法收集1998至2003年我院诊断为UC的住院患者45例,老年组(年龄≥60岁)15例,老年前期组(45～59岁)7例,＜45岁组23例。判断病情严重程度,并对年龄、性别、腹痛、大便性状、内镜表现等临床特点进行分析。结果腹痛、腹泻、便血均为常见症状,老年前期组的腹泻(85．7%)、黏液血便(85．7%)、体重减轻(85．7%)症状最为明显,老年UC患者次之(分别为73．3%、73．3%和60．0%)。而发热症状以老年患者最多见(60．O%)。老年UC多为轻度(80．0%),中、重度比例少(20．0%)。内镜下,老年组UC病变范围以直胸+乙状结肠及左半结肠所占比例为高(73．3%),而老年前期组和＜45岁组UC病变以全结肠及广泛结肠的构成比高(42．8%、34．8%)。老年UC内镜下主要表现为弥漫性黏膜水肿(100．0%)、糜烂浅溃疡(80．0%)和散在出血点(33．3%)。结论老年UC患者以轻度居多,临床及内镜有其特点,临床上应加以重视。

Objective Retrospective study was carried out to describe the clinical pattern, colonoscopic features of UC in patients older than 60 years, less than 60（45-60 years）, and younger than 45 years of age. Methods From 1998 to 2003, 45 in-hospital cases as UC were studied, including the severity of illness, abdominal pain, nature of feces, endoscopic findings etc, for each age group. Results There were 15 cases in those 〉60 years and 7 cases between 45-60 years of ages and 23 cases under 45 years of ages. Among all clinical manifestations, the incidences showed as the followings： frequent diarrhea （85.7 %）, weight loss （85. 7 %） and stool with mucus and blood（85.7%）. They were the most common in the pre-elderly group but lesses as 73.3%, 73.3%, 60.0% respectively for the elderly group, together with presence of fever（60.0%） . Furthermore, the common colonscopic findings in the elderly were mucosal edema（ 100 %）, erosion and ulceration（80.0 % ）, scattered hemorrhagic spots （33.3 % ）. Conclusion The incidence of UC in people older than 60 years is not rare, most of them with mild degree of sevesity. There are certain clinical characteristics and colonoscopic features deserving to be noticed in clinical practice.