溃疡性结肠炎367例复发患者5年随访观察

Results of a 5-year population-based followed-up for 367 ulcerative colitis patients

目的 分析溃疡性结肠炎（UC）患者的资料,探讨UC复发的临床特点以及复发相关因素.方法 统计分析解放军总医院1994至2005年,确诊并住院治疗的溃疡性结肠炎患者525例临床资料.分析其中367例复发患者的年龄、性别以及复发的可能因素,治疗时间和复发的时间等.结果 1994至2005年,共有525例UC住院患者,367例患者复发,复发率为69.9%,中位年龄42岁,男女比例为1∶3.13 其中263例接受随访,随访率为50.1%.分析复发因素中,UC患者女性比例明显高于男性（P≤0.05）,老年人（≥60岁）比例明显低于其他年龄段（P＜0.05） C-反应蛋白（CRP）水平对复发无影响（P＞0.05）.随访患者中,1年内36.5%复发,2年内75.3%复发,5年内87.8%复发,中位维持治疗时间（16.3±3.9）个月.复发组中停药后复发患者142例（61.5%） 维持治疗中复发患者26例（11.3%） 未治疗患者63例（27.2%）.复发组和无复发组之间,病情程度（P＜0.05）、病变部位（P＜0.05）与维持治疗时间（P＜0.05）差异有统计学意义.结论 女性UC患者复发率高于男性,老年人复发率低于其他年龄段,病变部位、病情程度、维持治疗时间与UC复发相关.

Objective To investigate the prognostic and relapsing factors of ulcerative colitis by a 5-year population-based follow-up. Methods A total of 525 patients diagnosed with ulcerative colitis during the period from 1994 to 2005 at our hospital were recruited and followed prospectively for 5 years or until a relapse. The evaluation at 5 years included interview, clinical examination, laboratory tests and colonoscopy. Results Among these patients, 367 patients suffered from a relapse of ulcerative colitis with a median age of 42 years old. And 263 （ 50. 1 % ） patients took part in the follow-up study. The median duration of maintenance treatment was （ 16. 3 ± 3. 9 ） months. The proportion of relapse was significant greater in females （ P 〈 0. 05 ） and in patients over 60 years old versus those under 60 （ P 〈 0. 05 ）. The value of CRP was unrelated with the relapsing rate（ P 〉0. 05 ）. During the follow-up, 36. 5% of the patients relapsed within 12 months, 75.3% within 2 years and 87. 8% within 5 years. And 61.5% of the patients relapsed after drug withdrawal, 11.3% in maintenance treatment and 27.2% with no treatment. Severity,extent of disease and duration of maintenance treatment showed significant differences between the relapsing group and relapsing-free groups （ P 〈 0. 05 ）. Conclusion The relapsing factors of ulcerative colitis are gender, age, severity, extent of disease and duration of maintenance treatment.