结肠黑变病临床特点及其与大肠息肉 大肠癌关系的回顾性分析

A Retrospective Study on the Clinical Characteristics of Melanosis Coli and the Correlation of Melanosis Coli with Colorectal Polyps and Colorectal Cancer

目的：探讨结肠黑变病（melanosis colic，MC）发病特点及其与大肠息肉、大肠癌的关系。方法：回顾分析156例MC患者临床特点和结肠镜下表现。结果：MC检出率为1．12％（男0．46％，女0．66％），82．69％患者有不同程度便秘和服用泻药史。83．97％表现为全结肠黑变，MC患者27．56％的息肉伴发率和同期接受结肠镜检查者息肉检出率无显著差异（X2=1．205，P=0．298），8．97％的大肠癌检出率与同期大肠癌检出率也无显著差异（x2=O．268，P=O．604），logistic回归分析表明MC患者年龄越大，发生MC及伴发息肉的可能性越大。结论：1）MC可能与便秘、长期服用泻药有关，以全结肠黑变为多，女性发病年龄较早，检出率较高；2）年龄越大，MC检出率越高，且伴发息肉可能性越大。

Objective： To investigate the clinical characteristics of melanosis coil （MC） and its correlation with colorectal polyps and colorectal cancer. Methods： Data from a total of 156 MC patients diagnosed by colonoscopy were retrospectively analyzed. Results： The detection rate of MC was 0.46% in the male patients and 0.66% in the female patients. The average age of the male patients was 65.53±13.08 years, older than that of the female patients at 53.73±13.50. Of these 156 patients, 82.69% had constipation and history of laxa- tive use, and 83.97% had involvement of the entire large intestine. The detection rates of colorectal polyps and colorectal cancer in MC patients were 27.56% and 8.97%, respectively, not significantly different from those in patients who received colonoscopy as a general precaution in the same period. Binary logistic regres- sion analysis showed that older MC patients had a higher detection rate of colorectal polyps. Conclusion： MC is probably related to constipation and an extended history of laxative use. Most of MC patients have the en- tire large intestine involved. Female MC patients are younger than male MC patients and have a higher detec- tion rate. Older MC patients have a higher possibility of having accompanying polyps.