克罗恩病与溃疡性结肠炎的临床特点分析

Analysis and comparison of clinical characteristics of Crohn′s disease and Ulcerative colitis

目的:分析比较克罗恩病和溃疡性结肠炎的临床特点。方法:回顾性分析17例克罗恩病和38例溃疡性结肠炎患者的临床表现、内镜特点及病理改变。结果:克罗恩病平均发病年龄早于溃疡性结肠炎(P<0.05);消瘦、发热以克罗恩病明显多见(P<0.05),而血便、里急后重以溃疡性结肠炎多见(P<0.05),腹痛、腹泻两者无明显差别;克罗恩病可累及全消化道,以回盲部为主(P<0.01),而溃疡性结肠炎则仅累及直肠和结肠(P<0.01);鹅卵石样改变、裂隙样溃疡等内镜表现仅见于克罗恩病(P<0.01);非干酪样肉芽肿、全层壁慢性炎、裂隙样溃疡和瘘管等病理改变亦仅见于克罗恩病(P<0.01)。结论:克罗恩病的发病年龄早于溃疡性结肠炎,两者临床表现多样,确诊需要依靠内镜和病理检查。

Objective To analyze and compare the clinical characteristics of Crohn′s disease（CD） and ulcerative colitis（UC）.Method The clinical manifestations,endoscopic features and pathological changes in 17 cases with CD and 38 cases with UC were retrospectively analyzed.Results The average age of onset in patients with CD was earlier than with UC（P0.05）.Weight loss and fever were obviously more common in patients with CD（P0.05）,while bloody stool and tenesmus were more common in UC cases（P0.05）.Abdominal pain and diarrhea showed no apparent difference in both diseases.CD involved the entire alimentary tract,particularly ileocecal junction（P0.01）,while UC involved only rectum and colon（P0.01）.Under endoscopy,the cobblestone sign and fissured ulcers were only revealed in CD（P0.01）,as well as pathological changes such as noncaseating glanulomas,chronic transmural inflammation,fissural ulcer and fistula（P0.01）.Conclusion The onset age of CD is earlier than that of UC,and both diseases shows various clinical manifestations.It depends on endoscopy and pathological examination to confirm the diagnosis.