嘉兴市缺血性结肠炎近10年发病趋势和临床特征回顾

Retrospective study on the incidence trend and clinical characteristics of ischemic colitis in recent ten years of Jiaxing City

目的 增加对缺血性结肠炎发病趋势的认识,提高诊治水平.方法 对2004年1月至2013年12月10年间住院治疗的89例缺血性结肠炎患者的临床资料作回顾性分析,以同期诊断为“慢性结肠炎”患者100例作为对照组.将缺血性结肠炎患者的实验室检查结果与对照组进行比较.非正态分布数据采用非参数检验.结果 近10年来缺血性结肠炎患者年住院人次、占全院年住院人次比例逐年增加,分别从2004年的1人次、0.01％上升到2013年的41人次、0.11％.89例患者平均年龄为（63.5±12.7）岁;男女比例为1∶2.18,基础疾病以高血压病最多,占43.8％（39/89）;38例既往有腹部手术史,其中有阑尾切除术史18例,占20.2％.78例有腹痛、便意症状,74例有便血主诉.缺血性结肠炎患者空腹血糖、三酰甘油、总胆固醇、血小板水平、凝血酶原时间与对照组比较差异均无统计学意义（P均＞0.05）,但CRP、D-二聚体水平均高于对照组（89.21mg/L比61.29 mg/L,90.13 μg/L比59.39 μg/L;Z=-3.959,-4.377;P均＜0.05）.CT表现为病变肠段肠壁增厚.结肠镜提示病变部位集中于左半结肠及直肠,占93.88％（138/147）.平均住院日为（10.59±5.97）d,复发率为3.37％（3/89）;慢性病例为2.25％（2/89）;无死亡病例.结论 缺血性结肠炎发病率近年明显增加,凡是有腹痛和（或）便血的患者均应考虑,60岁以上老年患者尤其应重视,尽早行结肠镜检查有助于临床诊断.

Objective To increase the awareness of the incidence trend of ischemic colitis and improve the level of diagnosis and treatment.Methods From January 2004 to December 2013,the clinical data of 89 in patients with ischemic colitis were retrospectively analyzed.At the same period,100 patients diagnosed as chronic colitis were enrolled as control group.The laboratory findings of patients with ischemic colitis were compared with those of control group.Non normal distribution data were analysed by non parametric test.Results The annual person-times of patients with ischemic colitis and the percentages accounted in the whole hospital annual person-times increased year by year in recent 10 years,which was one person time and 0.01% in 2004 increased to 41 person-times and 0.11% in 2013.The average age of the 89 patients was （63.5±12.7） years,and the male to female ratio was 1∶2.18.The most common underlying disease in the 89 patients was hypertension,accounted for 43.8%.Thirty-eight patients had a history of abdominal surgery,and eighteen patients with appendectomy,accounted for 20.2%.Seventy-eight patients had abdominal pain and defecation desire.Seventy-four patients complained of hematochezia.Compared with control group,there was no statistically significant difference in fasting blood glucose,triglyceride,total cholesterol,blood platelet levels and prothrombin time （all P〉0.05）.While the levels of C reactive protein and Ddimer were higher than those of control group （89.21 mg/L vs 61.29 mg/L,90.13 μg/L vs 59.39 μg/L; Z=-3.959,-4.377; both P〈0.05）.The images of computed tomography （CT） indicated thickened bowel wall in lesion segment.The results of colonoscopy showed that in the left colon and rectum were the predilection sites,accounted for 93.88% （138/147）.The average hospital stay was （10.59 ± 5.97） days and t he recurrence rate was 3.37 % （3 / 89）.The percentage of chronic cases was 2.25 % （2/89）,and no death was reported.Conclusions The incidence of ischemic colitis significantly increased in recent years.Patients with abdominal pain and/or hematochezia should be considered,especially those over 60 years old.Receiving colonoscopy as earlier as possible was helpful for the diagnosis.