中国溃疡性结肠炎10218例的特点

Features of ulcerative colitis in China:An analysis 10 218 cases

目的分析中国溃疡性结肠炎患者的特点.方法对从1981年到2000年20年间中国医学文献报告及我院确诊的10218例患者进行分析结果①病例数目:20年间,中国医学文献报告及我院确诊的患者共10218例,其中最近10年报告的病例数目是前10年3.8倍.②病变范围:直肠乙状结肠炎和直肠炎占70.20%,左半结肠炎占22.50%,广泛性或全结肠炎占7.30%.③病变类型:初发型34.8%,慢性反复发作型:52.6%,慢性持续性10.7%,急性暴发性:1.9%.④病程:75.5%患者小于5年,15.5%患者在5年和10年之间,只有9.1%患者大于10年.⑤肠外表现:6.1%患者有肠外表现.⑥年龄:发病的平均年龄是40.7岁(范围从6岁～80岁,高峰年龄段是30岁～49岁).⑦性别:男女比是1.09.⑧吸烟:病情严重程度和吸烟之间无负相关(P>0.05),⑨家族遗传性:270例患者中有4例有家族史.⑩治疗:单纯采用西药(氨基水杨酸类或/和皮质激素)治疗的占18.6%,单纯采用中医治疗的占20.1%,采用中西医结合治疗的占59.1%,手术1.3%,其他治疗占0.9%.结论中国溃疡性结肠炎的病例数目在过去10年中显著增加,病变主要以左半结肠为主,病程短,肠外表现少见,发病年龄相对较大,男女比例数目大致相等,家族遗传少见,吸烟与病情轻重之间无显著相关,中医药治疗在中国广泛应用.

AIM To analyze the characteristics of ulcerative colitis (UC)in China. METHODS A total of 10 218 patients of UC reported in Chinese medical literature and diagnosed in our hospital from 1981 to 2000,according to the diagnostic criteria of Lennard-Jones were analyzed. RESULTS The number of cases increased by 3.08 times over the past 10 years(2506 patients were diagnosed from 1981 to 1990 while 7512 patients were diagnosed from 1991 to 2000).Lesion range was described in 7966 patients, 5592(70.20%)had proctosigmoiditis or proctitis,1792 (22.50%)had left-sided colitis,and 582(7.30%)had pancolitis.Among 8122 patients,2826(34.8%)had first episode,4272 had chronic relapse(52.6%),869(10.7%) were of chronic persistent type,and 154(1.9%)were of acute fulminant type.The course of the illness was described in 5867 patients,4427(75.5%)of them had a course of less than 5 years,919(15.5%)between 5 years and 10 years,and 530(9.1%)more than 10 years.Six hundred and sixteen patients(6.1%)had extraintestinal manifestations.The mean age at the diagnosis was 40.7 years(range 6-80 years,the peak age range 30-49 years).The male to female ratio was 1.09.Among 270 patients diagnosed in our hospital,36 patients had histories of smoking,there was no negative association between the severity of UC and smoking (P>0.05),21 smokers were followed up for one year,15 of them give up smoking when the disease was diagnosed,and one year later,7 patients relapsed,6 patients did not give up smoking,and 2 patients relapsed one year later.Among 270 UC patients diagnosed in our hospital,4 patients (1.48%)had family histories of UC.Treatment was mentioned in 6859 patients,western medicine (aminosalicylate and/or corticosteroid) was administered in 1276 patients(18.6%),traditional Chinese medicine (Chinese herbs) was adopted in 1377 patients(20.1%), integrated western medicine and traditional Chinese medicine was adopted in 4056 patients(59.1%),surgical treatment in 87 patients(1.3% ),and other treatment in 63 patients(0.9%). CONCLUSIONS In China,the number of UC patients increased significantly in the past 10 years.Lesions are commonly located in the left side colon.The course is short with rare extraintestinal manifestations.The age of onset is relatively high.Male and female are nearly equally affected.No negative relationship was found between smoking and severity of the disease.Familial relatives are rarely involved The traditional Chinese medicine(TCM)is widely used in the treatment of UC.