老年溃疡性结肠炎患者的临床、内镜和病理分析

Analysis of the clinical,endoscopic and pathological features between the aged and non-aged patients with ulcerative colitis

目的探讨老年溃疡性结肠炎患者的临床、内镜和病理特点及与非老年患者的差异。方法收集分析2000年1月至2008年12月在我院诊断为溃疡性结肠炎349例患者的相关资料,对老年(≥60岁)溃疡性结肠炎患者与非老年(<60岁)溃疡性结肠炎患者的临床表现、内镜和病理特点进行比较分析。结果老年组68例,男性37例,女性31例,年龄(68.54±7.16)岁;非老年组281例,男性150例,女性131例,年龄(42.38±10.88)岁。老年溃疡性结肠炎患者中腹泻、腹痛和便血等临床表现的发生率与非老年患者均无显著性差异(P>0.05)。老年组病情轻度患者占60.3%,较非老年组多(P<0.05)。内镜下老年组溃疡性结肠炎病变范围以直肠、直乙状结肠及左半结肠多见,但与非老年组相比差异无统计学意义(P>0.05)。在病理学上老年组异型增生的发生率显著高于非老年组(P<0.05)。结论老年溃疡性结肠炎患者的病情相对较轻,但异型增生发生率较高,应加以重视。

Objective To analyze the clinical, endoscopic, and pathological features of aged patients with ulcerative colitis and the difference between the aged and non-aged patients. Methods The clinical, endoscopic, and pathological data from 349 ulcerative colitis patients admitted in Huadong Hospital from January 2000 to December 2008 were reviewed and analyzed retrospectively. The patients were divided into two groups： aged group （≥60 years） and non-aged group （ 〈60 years）. Results Of the 349 patients, 68 patients were classified as aged group [male to female： 1.19： 1, mean age： （68.54 ±7.16） years old]. The other 281 patients were classified as non-aged group [male to female： 1.15： 1, mean age： （42.38 ± 10.88） years old]. There was no significant difference in the incidence of clinical manifestations such as diarrhea, celialgia and hemafecia, etc. （P 〉 0.05） between the two groups. The disease of aged patients was less severe than that of the non-aged patients （P 〈0.05）. The lesions of the aged patients were more located at the rectum, sigmoid colon, and left hemicolon, but no significant difference in the extent of disease was found between the two groups （P 〉 0. 05）. The occurrence of dysplasia in the aged patients was higher than that in the non-aged patients （P 〈0. 05）. Conclusion The degree of severity of the aged patients with ulcerative colitis is comparatively mild, but the occurrence of dysplasia is more frequent.