溃疡性结肠炎的肠外表现

The systemic manifestations of ulcerative colitis

目的 分析溃疡性结肠炎 (UC)伴随的肠外表现 ,探讨其与病变部位和疾病程度之间的关系。方法 采用 χ2 检验方法对 392例UC患者进行回顾性分析。结果 392例UC患者中 ,82例(2 0 9%)有肠外表现 ,其中 34例 (8 7%)有 1种以上肠外表现 ;全结肠型与左半结肠型UC患者肠外表现的发生率均较单纯直肠型者增高 (P <0 0 5 ) ,其中全结肠型的发生率最高 ,左半结肠型次之 ,单纯直肠型最低 ,呈递减趋势 ,但前二者间差异无显著性 (P >0 0 5 ) ;各种常见肠外表现的发生率在重度UC患者较轻度明显升高 (P <0 0 5 ) ,从轻度、中度到重度呈递增趋势 ;除强直性脊柱炎、原发性硬化性胆管炎等外 ,多数肠外表现的发生与UC活动性密切相关 ,经氨基水杨酸类和 (或 )皮质类固醇治疗后消失。结论 UC患者肠外表现发生率较高 ,累及的部位依次为关节、肝胆、皮肤、口腔和眼睛。UC肠外表现的发生与病变部位和炎症程度密切相关。多数肠外表现与UC活动性相关 ,但与UC预后无明显关系。

Objective To probe the relationship between location and extent of ulcerative colitis (UC) by analyzing its extra intestinal manifestations Methods 392 UC cases in Peking Union Medical College Hospital from 1976 to 2000 were reviewed retrospectively Chi square test was used to test the difference between groups Results 82 of 392 patients (20 9%) with UC had extra intestinal manifestations,34 (8 7%) of these patients had more than one extra colonic organ involvement; It shows that the extensive colitis has highest incidence of extra intestinal manifestations with UC than that of the left sided colitis did, while the proctitis had the lowest incidence There were no significant difference( P >0 05)between the group of extensive colitis and that of left side colitis; The incidence of extra intestinal manifestations in severe cases was significantly greater than that in mild cases There was a trend of increasing incidence from severe to moderate to mild type ( P <0 05); Most of the extra intestinal manifestations were associated with active UC, except for AS?PSC, healed during SASP and/or steroid treatment Conclusions Extra intestinal manifestations had a high incidence in UC The most frequently involved organs were joints, hepatobiliary system, skin, mouth and eyes The majority of them were associated with the active UC The incidence of extra intestinal manifestations with UC was closely related with the extent and severity of the lesions, and the most of the extra intestinal manifestations occurred in the active phase of UC But the incidence of extra intestinal manifestations was not related to prognosis