新疆地区溃疡性结肠炎复发相关因素探讨

Study of recurr.ence factors of ulcerative colitis in Xinjiang district

目的探讨溃疡性结肠炎（uc）复发的临床特点以及复发相关因素。方法随访并统计分析2006—2009年新疆维吾尔自治区人民医院确诊的137例初发型UC患者的临床资料及复发情况。结果137例患者经治疗完全缓解率为38．69％（53／137），部分缓解率61．31％（84／137），总有效率为100％（137／137）。1年累积复发率为26．28％（36／137），2年累积复发率49．64％（68／137），3年累积复发率59．85％（82／137）。其中偶发（≤1次／年）者37例，占27．01％（37／137）；频发（≥2次／年）者45例，占32．85％（45／137）；55例患者（40．15％，55／137）经首次治疗，随访期间未复发。复发与性别无关（P〉0．05）。〈50岁组的复发率为68．09％（64／94），显著高于≥50岁组[41．86％（18／43）]（X2=8．444，P〈0．05）。维吾尔族患者的复发率为70．42％（50／71），显著高于汉族[48．48％（32／66）]（X2=6．851，P〈0．05）。左半结肠的复发率为71．64％（48／67）、广泛结肠的复发率为71．88％（23／32），显著高于直肠的28．94％（11／38）（P〈0．05）。重度组的复发率为82．61％（19／23）显著高于轻度组的52．38％（33／63）和中度组的58．82％（30／51）（P〈0．05）。维持缓解组接受维持治疗者占52．73％（29／55），显著高于复发组的31.71％（26／82）（X。：6．053，P〈0．05）。精神紧张可能是导致uc复发最重要的诱因，占64．63％（53／82），其次为饮食不当和劳累过度，分别占56．10％（46／82）和39．02％（32／82）。结论维吾尔族UC患者复发率高于汉族，青壮年的复发率高于中老年人，病变范围、病情严重程度、能否维持治疗与UC复发相关，精神紧张、饮食不当和劳累过度是UC复发的危险因素。

Objective To investigate clinical characteristics and related factors of ulcerative colitis （UC）. Methods One hundred and thirty-seven newly diagnosed patients with UC from 2006 to 2009 in the People＇s Hospital of Xinjiang Uygur Autonomous Region were selected as our subjects. The clinical data were recorded and the patients were followed up for 3 years. Results Of 137 patients,complete remission rate was 38. 69% （53/137）, and partial response rate was 61.31% （84/137）. The overall effective rate was 100% （137/137）. The 1-year cumulative relapse rate was 26. 28% （36/137） , and 2-year cumulative relapse rate was 49. 64% （68/137） ,59. 85% （82/137） for 3-year cumulative relapse rate. The occasion rate （≤1 time/year） was 27. 01% （37/137）, and frequency （ ≥ 2 times/year） was 32. 85 % （45/137）. Fifty-five patients （40. 15 % （55/137）） were no recurrence within 3 years. Relapse rate were not relate to gender （P 〉0. 05）. The relapse rate of patients less than 50 years was 68. 09% （ 64/94 ） substantially higher than that over 50 age group （41.86% （ 18/43 ）, X2 = 8.444, P 〈 0.05 ）. The relapse rate of Uygur patients （ 70.42%, 50/71 ） was substantially higher than the Han （48.48 % （ 32/66 ）, X2 = 6. 851, P 〈 0. 05 ）. The relapse rate of left colon and extensive colon were 71.64% （48/67） and 71.88% （23/32） , higher than that of rectum（28.94% ,11/38） （P 〈 0. 05 ）. The relapse rate of severe group （82. 61%, 19/23 ） was higher than that of the mild （52. 38 %, 33/63 ） and moderate groups （ 58.82%, 30/51 ） （ P 〈 0. 05 ）. In maintenance of mitigation group, 52. 73% patients （29/55） were received maintenance treatment and relapse of those patients were significantly higher than recurrence group （31.71% ,26/82,P 〈 0.05 ）. Mental stress may be the top one risk factor, which lead to recurrence of UC （64. 63% ,53/82） ,followed by imbalance diet（56. 10% ,46/82） and overwork（39.02%, 32/82）. Conclusion Relapse rate of the Uygur UC patients was higher than that of the Han, and young adults has the higher recurrence rates than the elder. The factors of lesion extent, severity, ability to maintain treatment are related to recurrence of UC. Stress,imbalance diet and overwork are risk factors of recurrence of UC.