近10年中国溃疡性结肠炎临床特点分析

Clinical features of ulcerative colitis in China in the last 10 years

目的总结分析中国近10年文献报道的溃疡性结肠炎(UC)患者的临床特征。方法以"炎症性肠病"及"溃疡性结肠炎"为检索词分别在中国知网、维普网、万方数据库中进行系统检索。由2名研究者对纳入文献进行数据提取。总结UC的人口特征、临床表现、类型、内镜及病理表现、治疗。最后对提取的数据使用Excel表格进行统计分析。结果最终纳入文献101篇,共计19 770例UC患者中,男女比例为1. 18∶1,平均年龄为43. 3。临床表现方面,17 411例UC患者中,主要为血便(71. 23%)、腹泻(69. 46%)、腹痛(63. 44%)、黏液便(53. 68%)。肠外主要累及关节、口腔及肝胆系统,少有累及皮肤及眼部。临床类型以慢性复发型为主。病变范围以左半结肠型多见。UC患者(11 861例)内镜下主要表现主要为充血水肿(76. 44%),溃疡或糜烂(69. 81%),脆性增加、接触性出血(30. 68%),脓性分泌物(15. 87%)。病理表现表现多为黏膜急慢性炎性改变、糜烂溃疡、隐窝脓肿以及炎性细胞浸润。治疗方式以5-氨基水杨酸类(5-ASA,5-aminosalicylic acid)、皮质醇等内科治疗为主,病情程度较重可选择手术、白细胞吸附术。结论国内文献报道UC多见于中年男性,以腹痛、腹泻、黏液血便为主要表现,可累及关节、口腔等肠外器官,治疗以内科治疗为主,确定UC的严重程度和病变范围对于选择最合适的治疗方法非常重要。

Objective To investigate the clinical features of patients with ulcerative colitis( UC) reported in the literature in China in the last 10 years. Methods The ″inflammatory bowel disease″ and ″ulcerative colitis″ were searched in the CNKI,VIP and Wanfang database. Summarize the demographic characteristics, clinical manifestations, types, endoscopy and pathological manifestations,and treatment of UC. Finally,the extracted data is statistically analyzed using the Excel. Results Of all 19770 patients with UC,the male to female ratio was 1. 18∶ 1,and the average age was 43. 3. Of 17411 patients with UC,the main clinical manifestations of were bloody stool( 71. 23%),diarrhea( 69. 46%),abdominal pain( 63. 44%) and mucous stool( 53. 68%).Extraintestinal manifestations involve mainly in the joints,mouth and hepatobiliary system,rarely involving the skin and eyes. The clinical type was mainly chronic recurrence type. The lesion scope is more common in the left colon type. Of 11861 patients with UC,endoscopic findings are mainly congestion and edema( 76. 44%),ulcer or erosion( 69. 81%),increased fragilityand contact bleeding( 30. 68%),Purulent secretion( 15. 87%). The pathological manifestations were acute and chronic mucosal changes,erosion and/or ulceration,crypt abscess,inflammatory cells infiltrating mucosa,etc. The treatment is still based on medical treatments such as 5-aminosalicylic acid and cortisol. Patients with severe disease can choose surgery or Granulocyte and monocyte adsorption apheresis.Conclusion The number of male patients with ulcerative colitis is more common in middle-aged men. The clinical manifestations are abdominal pain,diarrhea and mucus and blood. And Extraintestinal manifestations involve mainly in the joints and mouth. The main treatment is medical treatment,determining the severity and extent of ulcerative colitisis important for selecting the most appropriate treatment.