溃疡性结肠炎和克罗恩病临床特征分析

Analysis of Clinical Characteristics of Ulcerative Colitis and Crohn' s Disease

背景:溃疡性结肠炎(UC)和克罗恩病(CD)的发病率逐年升高,且极易误诊。目的:分析UC和CD的临床特征。方法:收集2003年1月～2012年6月湖南省人民医院83例UC和28例CD病例,回顾性分析患者的病变范围、实验室检查、并发症、治疗和误诊特点。结果:UC患者明显多于CD患者,UC病变部位以左半结肠为主,CD以回肠、末端回肠为主。UC病变范围和病情程度与CD相比差异均有统计学意义(P<0.05)。UC、CD患者血红蛋白(Hb)、白蛋白(ALB)降低,红细胞沉降率(ESR)、C反应蛋白(CRP)升高,但两者相比无明显差异(P>0.05)。CD常见并发症为肠梗阻、肛瘘,其并发症发生率显著高于UC(P<0.05)。UC治疗以氨基水杨酸为主,CD以手术治疗更多见。UC的复发率、误诊率与CD相比均无明显差异(P>0.05)。结论:UC患者以轻中度为主,并发症较少,治疗以内科治疗为主;重度CD患者多见,并发症多,手术率相对较高。UC和CD的复发率和误诊率均高,应早诊断、早治疗。

Background： Incidences of ulcerative colitis （UC） and Crohn＇ s disease （CD） are increasing in recent years, and UC and CD are easily misdiagnosed. Aims： To analyze the clinical characteristics of UC and CD. Methods： Eighty-three cases of UC and 28 cases of CD at Hunan Provincial People＇ s Hospital from January 2003 to June 2012 were enrolled, and data of lesion location, laboratory examination, complication, treatment and misdiagnosis were retrospectively analyzed. Results： The incidence of UC was higher than CD. Lesions of UC were commonly located in left hemicolon, while CD lesions were mostly located in ileum and terminal ileum. Statistical significances in lesion location and severity were found between UC and CD （P 〈 0.05）. Hemoglobin （Hb） and albumin （ALB） were reduced, and erythrocyte sedimentation rate （ESR） and C-reactive protein （CRP） were increased in UC and CD, but no significant difference was found between the two groups. Ileus, anal fistula were the common complications in CD, and the complication rate was significantly higher in CD than in UC （P 〈 0.05 ）. Aminosalicylic acid was the main treatment in UC and surgery was frequently performed in CD. No significant differences in recurrence and misdiagnosis rates were found between the two groups （ P 〉 0.05）. Conclusions： Most of UC are mild or moderate with less complications, and medical treatment is the main therapy. Whereas severe CD with complications are more common, and surgery rate is high. The recurrence and misdiagnosis rates of UC and CD are high, and early diagnosis and treatment are mandatory.