新疆地区初发型广泛型溃疡性结肠炎67例临床特征分析

Clinical characteristics of 67 cases of new-onset diffuse type ulcerative colitis

目的分析初发型广泛型UC的临床特征。方法回顾性分析新疆维吾尔自治区人民医院2007年5月至2013年3月确诊为初发型UC并住院治疗患者的病历资料，比较广泛型、直肠型及左半结肠型患者的民族构成比、性别比、诊断时年龄、居住环境、疾病严重程度、临床症状、实验室检查结果、结肠镜结果及病理组织学检查结果。三组间比较时，正态分布资料采用单因素方差分析，偏态分布资料及等级资料采用Kruskal-WallisH检验，计数资料采用卡方检验。结果共纳入初发型广泛型UC患者67例，其中汉族、维吾尔族及哈萨克族分别为22例（32．8％）、39例（58．2％）、6例（9．0％），男女性别比为1．48：1，诊断时的平均年龄为（43．27±16．91）岁，城市与农村患者比为3．19：l，疾病严重程度以轻度多见，轻、中、重度分别为38例（56．7％）、14例（20．9％）、15例（22．4％）。症状主要以腹痛、腹泻及黏液脓血便多见，部分患者可有发热及里急后重，少数患者伴有腹胀、恶心呕吐及外周关节炎。ESR加快、超敏CRP升高及血浆纤维蛋白原升高分别占37．3％（25／67）、44．8％（30／67）、31．3％（21／67）。与初发型直肠型UC及初发型左半结肠型UC相比，初发型广泛型UC患者腹痛、腹泻、重度、维吾尔族多见及Mayo评分较高。且腹痛、腹泻、重度、维吾尔族及Mayo评分在三组间的两两比较中差异有统计学意义（P均〈0．017）。结论新疆地区初发型广泛型UC以腹痛、腹泻及维吾尔族多见，Mayo评分较高，病变以轻中度为主，与直肠型及左半结肠型比较，重度明显增多。

Objective To analyze the clinical characteristics of new-onset diffuse type ulcerative colitis. Methods From May 2907 to March 2012, clinical data of hospitalized patients diagnosed in the People＇s Hospital of Xinjiang Autonomous Region as new-onset ulcerative colitis were retrospectively analyzed, and constituent ratios of nationality, gender, age at diagnosis, residential environment, severity of disease, clinical symptoms, results of laboratory examination, results of colonoscopic examination and results of histopathological examination were compared among the diffuse type, the type of proctosigmoiditis and the type of left-sided colitis. Normal distribution data were analyzed by one-wayanalysis of variance, skew distribution data and ordinal data were analyzed by Kruskal-Wallis H test, and count data were analyzed by chi-square test in the comparison among the three groups. Results A total of 67 patients with new-onset diffuse type ulcerative colitis were enrolled. The constituent ratios of Han nationality, Uygur nationafity and Kazak nationality were 32.8% （22/67）, 58.2% （39/67）, and 9.0% （6/ 67）, respectively. The ratio of male to female was 1.48：1. The age at diagnosis was （43.27 ± 16.91） years old. The ratio of city to countryside was 3. 19 ： 1. To the severity of the disease, mild was more common, the proportion of mild, moderate and severe were 56.7M（38/67）, 20.9%（14/67） and 22.4% （15/67）, respectively. Abdominal pain, diarrhea and purulent stools were the predominant symptoms. Some patients might have fever and tenesmus, a few patients accompanied with abdominal distension, nausea, vomiting and peripheral arthritis. The percentage of increasesed erythrocyte sedimentation rate, hypersensitive-C reation protein and plasmatic fibrinogen was 37.3% （25/67）, 44.8% （30/67） and 31.3% （21/67）, respectively. To compare with patients with proctosigmoiditis and left-sided colitis, the patients with new-onset diffuse type colitis had higher Mayo score and were more prone to develop abdominal pain, diarrhea, severe colitis, and were more common in Uygur nationality. There were statistical differences in abdominal pain, diarrhea, severity, ratio of Uygur nationality and Mayo score in pairwise comparison among the three groups （all P〈0. 017）. Conclusion more common in new-onset diffuse ulcerative colitis Abdominal pain, diarrhea and Uygur nationality are in Xinjiang Region, with relatively high Mayo score and mild to moderate degree, while severity significantly increased compared to the type of proctosigmoiditis and the type of left-sided colitis.