海南炎症性肠病单中心临床资料分析

Analysis of clinical data of patients with inflammatory bowel disease in Hainan

目的：总结分析海南省人民医院炎症性肠病（IBD）的临床特点,指导临床诊治。方法 ：对2002年1月-2014年7月海南省人民医院确诊为IBD的271例病例进行回顾性分析。结果 ：IBD患者中男女之比为1.71∶1,平均发病年龄（48.19±17.04）岁。溃疡性结肠炎（ulcerative colitis,UC）患者以黏液或脓血便发生率最高（70.67%）,克罗恩病（Crohn＇s disease,CD）患者以腹痛发生率最高（76.09%）;CD组发热、贫血表现高于UC组,纳差则低于UC组（P〈0.05）。UC组中血钙水平与病变程度呈负相关（r=-0.136）,血小板（PLT）部分凝血活酶时间（APTT）、纤维蛋白原（FIB）、血沉（ESR）、C反应蛋白（CRP）与病变程度呈正相关。病情以轻度（17.71%）和中度（59.78%）为主。肠镜检查中UC以左半结肠病变为主（46.08%）,CD以回结肠病变为主（44.44%）;肠镜表现以充血水肿、糜烂、溃疡为主（87.08%）,病理改变以慢性炎性细胞浸润为主（81.92%）。治疗以氨基水杨酸类及类固醇激素为主。结论：海南省人民医院炎症性肠病住院人数呈逐年上升趋势。患者轻中度病变居多,肠外表现和并发症较少,治疗以氨基水杨酸类为主。IBD的临床特点与国外报道存在一定的差异。

Objective：To summarize and analyze the clinical features of inflammatory bowel disease and guide the clinical diagnosis and therapy.Methods：The clinical data of 271 patients with IBD were collected retrospectively from Hainan People＇s Hospital during January 2002 to July 2014.Results：Of these 271 patients,the ratio of male to female was 1.71∶1.The median age was（48.19±17.04）years.The main clinical manifestations of UC were mucus bloody stool（70.67%）.the main clinical manifestations of CD were abdominal pain（76.09%）.UC performance of loss of appetite was higher than CD,the performance of fever and anemia were reverse（P〈0.05）.Blood calcium level was negatively correlated to the degree of pathological changes in UC.PLT,APTT,FIB,ESR,CRP were positively correlated.Most of these patients were mild（17.71%）or moderate（59.78%）.The mainly lesion of UC was located in left colon（46.08%）,while the lesion of CD located in ileocolon（44.44%）.The main colonoscopy performances were congestion and edema,erosion,ulceration（87.08%）.The main pathological changes were chronic inflammatory cell infiltration（81.92%）.5-aminosalicylate（5-ASA）agents and glucocorticiods were the main therapy drugs.Conclusions：IBD has an ascending trend in our hospital year by year.There are some differences in the characteristics of patients with IBD and foreign reports.Most of them are mild or moderate,extm-intestinal manifestations and complications are rare.Aminosalicylate is the main treatment.