溃疡性结肠炎患者临床病理特点分析

Analysis of the clinical and pathological characteristics of patients with ulcerative colitis

目的 分析溃疡性结肠炎患者的临床病理特点.方法 收集2008年6月至2011年9月我院100例溃疡性结肠炎住院患者的临床、结肠镜及病理资料,进行回顾分析,并对14例不典型增生的患者依靠临床、结肠镜、病理手段进行1～3年随访.结果 病变范围：直肠10例（10％）,乙状结肠1例（1％）,直乙状结肠9例（9％）,左半结肠13例（13％）,广泛型10例（10％）,全结肠型52例（52％）,两端型5例（5％）.分度：重度47例（47％）,中度29例（29％）,轻度24例（24％）.患者的疾病严重程度与病变范围呈正相关（P＜0.05）.病理示非特异性急慢性炎,黏膜充血水肿、糜烂、溃疡,其中44例病理显示隐窝炎和（或）隐窝脓肿,55例杯状细胞减少,癌变2例（2％）,随访结果表明14例轻度异型增生患者未发现癌变,轻度异型增生与病变范围、严重程度及病程均相关性无关（P＞0.05）.结论 溃疡性结肠炎住院患者多为重度、全结肠患者,疾病严重程度与病变范围有关,总体癌变风险为2％.

Objective To analyze the clinical,endoscopic and pathological characteristics of patients with ulcerative colitis （UC）.Methods One hundred patients in our hospital from June 2008 to September 2011 were collected.The clinical,endoscopic and pathological data of patients with ulcerative colitis were analyzed.Meanwhile,the clinical presentations,endoscopic and pathological examination of 14 cases with mild-grade dysplasia were followed up for 1 to 3 years.Results The patients included into this study were 10 （10％） with rectitis,1 （1％） with sigmoiditis,9 （9％） with rectosigmoiditis,13 （13％） with left-sided colitis,10 with extensive colitis,52 （52％） with pancolitis and 5 （5％） with rectitis and right-sided colitis.According to clinical manifestations,patients were divided into mild disease group （24,24％）,moderate severity group （29,29％） and severe disease group （47,47％）.Positive correlation was found between the disease involvement extent and the severity （P ＜ 0.05）.Histomorphological changes were characterized by acute and chronic inflammatory cell infiltration,edema,erosion and ulceration.Forty-four patients were founded with crypt inflammation and abscess formation,55 with decreased number of goblet cells,2 with colorectal cancer and 14 with mild dysplasia.During the follow up period,we did not found cancer in the 14 patients with mild dysplasia.Mild dysplasia was no related to the extent of UC involvement,the severity and disease duration （P ＞ 0.05）.Conclusion Most of patients with ulcerative colitis in our hospital have severe pancolitis.The UC severity is related to the extent of UC involvement.The average carcinogenesis rate is 2％.