炎症性肠病合并自身免疫疾病临床特征及药物治疗

Clinical Features and Drug Treatment of Inflammatory Bowel Disease Complicated with Autoimmune Disease

目的探讨炎症性肠病(IBD)合并自身免疫疾病(AD)的临床特征及药物治疗情况。方法选取医院2016年12月至2018年12月收治的IBD合并AD患者70例,同期选取单纯IBD患者90例,进行对比分析。将患者分为4组,溃疡性结肠炎(UC)组51例,克罗恩病(CD)组39例,CD+AD组28例,UC+AD组42例。结果4组患者在年龄、性别、病变范围方面无明显差异(P>0.05);CD+AD组和UC+AD组患者的病程均明显较CD组和UC组长(P<0.05),CD+AD组和UC+AD组重度活动期患者均明显较CD组和UC组高(P<0.05),轻度活动期患者均明显较CD组和UC组低(P<0.05);CD+AD组和UC+AD组患者的肠外表现总发生率均明显较CD组和UC组高(P<0.05);肠外表现发生率最高的是关节炎;主要使用氨基水杨酸制剂治疗,部分患者联合使用免疫制剂、糖皮质激素;病情非常严重者或常规治疗无效果者,使用激素治疗,IBD+AD组患者激素的使用率明显比IBD组高。结论IBD合并AD患者病情更严重,临床表现多种多样,早期进行合理的内科药物治疗有利于缓解病情。

Objective To investigate the clinical features and drug treatment of inflammatory bowel disease(IBD)complicated with autoimmune disease(AD).Methods Totally 70 patients with IBD complicated with AD admitted to our hospital were selected from December 2016 to December 2018,and 90 patients with IBD were selected during the same period for contrastive analysis.The patients were divided into 4 groups:ulcerative colitis(UC)group(51 cases),Crohn's disease(CD)group(39 cases),CD+AD group(28 cases)and UC+AD group(42 cases).Results There was no significant difference in age,gender and lesion range among the four groups(P>0.05),the course of disease in CD+AD group and UC+AD group was significantly longer than that in CD group and UC group(P<0.05).The patients at severe active stage in CD+AD group and UC+AD group were significantly more than those in CD group and UC group(P<0.05),while the patients at mild active stage in CD+AD group and UC+AD group were significantly fewer than those in CD group and UC group(P<0.05).The total incidence of extra-intestinal manifestations in CD+AD group and UC+AD group was significantly higher than that in CD group and UC group(P<0.05).The highest incidence of extra-intestinal manifestations was arthritis.In terms of treatment drugs,aminosalicylic acid preparation was mainly used,immunotherapy agents and glucocorticoids were jointly used in some patients.Hormone treatment was used for patients with very serious illness or those who were ineffective in routine treatment,the use rate of hormones in IBD+AD group was significantly higher than that in IBD group.Conclusion Patients with IBD complicated with AD have more serious illness and various clinical manifestations,early rational medical treatment is helpful to alleviate the disease.