溃疡性结肠炎与缺血性结肠炎临床特征内镜特点相关分析

Clinical Characteristics of Ischemic Colifis and Ulcerative Colitis

目的:提高缺血性结肠炎(IC)和与溃疡性结肠炎(UC)诊断的正确率。方法:选择2008年1月至2011年6月的住院患者,确诊IC 43例,UC 36例,对其临床特征、内镜特点进行回顾性比较分析。结果:组间性别、年龄、病程和基础疾病比较差异有统计学意义(P<0.05),而主要临床表现比较,差异无统计学意义。IC组以老年女性多见,病程短,多伴发心脑血管等基础疾病(29/43,67.0%)。IC组C反应蛋白高于UC组,血小板低于UC组(P<0.05)。IC多累及乙状结肠,直肠少见;病变为区域局限性,溃疡为纵形或不规则形,病灶愈合迅速,病理以黏膜炎症为主。UC组病变多起源于直肠,一般累及肠壁全周,病变为倒灌连续性,以散在针尖样地图状溃疡为主,病理表现为隐窝炎和脓肿。结论:年龄、病程、基础疾病、C反应蛋白、内镜及病理特征是鉴别诊断的要点。

Objective： To compare the clinical characteristics of ischemic colitis（IC）and ulceratire colitis（UC）. Methods：The data of 43 IC patients and 36 UC patients diagnosed from January 2008 to June 201 1 were compared on the clinical and endoscopic characteristics. Results： There were statistical differences in terms of gender,age,course of disease and underlying diseases between the two groups（P0.05）.IC was more frequently seen in aged women with cardiovascular diseases,and with short course of disease（29/43,67.0%）.IC group showed higher CRP and lower PLT level than did UC group（P0.05）.IC mostly involved sigmoid colon,with localized lesions of vertical or irregular ulcer which cured more quick and characterized with mucosal inflammation,while UC mainly originated from rectum and involved the whole intestinal wall,manifested with scattered spot ulcer,eryptitis and abscess. Conclusion：Age,disease course,underlying diseases,sel31m CRP level,endoscopic and pathological characteristics are all factors to consider for differential diagnosis of 1C and UC.