摘要
目的 分析76例阿米巴肠炎患者的首发症状、易患因素、好发部位、影像学改变、内镜下表现、病理改变、预后、住院天数等临床特点,提高对该病的认识和诊治水平。方法 按照本研究的纳入和排除标准,回顾性收集2019年1月到2021年11月就诊于云南省第一人民医院并确诊阿米巴肠炎的76例患者的临床资料,并用Excel和SPSS 26.0进行统计分析。结果 76例阿米巴肠炎患者中,男性42例,女性34例,平均发病年龄为(49.42±15.32)岁,发病年龄中位数为51岁,男女发病年龄差异无统计学意义(P>0.05);男性患者平均住院天数11 d,女性患者平均住院天数9 d,男性患者和女性患者在住院天数、预后方面差异无统计学意义(P>0.05)。阿米巴肠炎的炎症性肠病组与非炎症性肠病组,在抗凝血酶原Ⅲ、血小板、D二聚体方面差异有统计学意义(P<0.05);在嗜酸性粒细胞绝对值、超敏C反应蛋白、血沉、血红蛋白、白细胞、中性粒细胞绝对值、年龄、性别、住院天数、预后方面差异无统计学意义(P>0.05)。结论 阿米巴肠炎患者的发病年龄以中年人为主,男性多于女性,男女发病年龄、住院天数、预后差异无统计学意义;炎性肠病、低蛋白血症、贫血、结缔组织病、幽门螺旋杆菌感染等是阿米巴肠炎患者的危险因素;农民是阿米巴肠炎的好发人群;绝大多数阿米巴肠炎患者以血性腹泻而就诊,其次是以腹痛就诊;阿米巴肠炎患者中,左半结肠(直肠、乙状结肠和降结肠)炎性改变最多见;粪便镜检联合结肠镜检可提高阿米巴肠炎的临床诊断率;阿米巴肠炎的炎症性肠病组和非炎症性肠病组在性别、年龄、炎症参数(超敏C反应蛋白、血沉)、预后、住院天数方面差异无统计学意义。
Objective susceptible factors, predilection site,imaging changes, endoscopic manifestations,pathological changes, prognosis,hospitalization days and so on, so as to improve the understanding of the disease and the level of diagnosis and treatment.MethodsAccording to the inclusion and exclusion criteria of this study, the clinical data of 76 patients with amoebic colitis diagnosed in the First People′s Hospital of Yunnan Province from January 2019 to November 2021 were collected retrospectively, and statistically analyzed by Excel and SPSS 26.0.ResultsAmong the 76 patients with amoebic colitis, there were 42 males and 34 females, with the average age of onset was(49.42±15.32) years old, the median age of onset was 51 years old. There was no significant difference in the age of onset between males and females(P>0.05). The average hospital stay for male patients was 11 days, and the average hospital stay for female patients was 9 days;there was no significant difference between male and female patients in hospitalization days and prognosis(P<0.05). In terms of laboratory index and curative effect, there were significant differences between inflammatory bowel disease Inflammatory bowel disease group and noninflammatory bowel disease group in antithrombin III, platelet and D dimer. There was no significant difference in absolute eosinophil count, hypersensitive C-reactive protein, erythrocyte sedimentation rate, age, leukocyte, absolute value of neutrophils, sex, hospital stay, prognosis(P>0.05).Conclusions male is more than female, and there is no significant difference in onset age, hospital stay and prognosis between male and female. Inflammatory bowel disease, hypoproteinemia, anemia, connective tissue disease and HP infection are the risk factors of amoeba colitis. Farmers are prone to amoeba colitis. The vast majority of patients with amoeba colitis were treated with bloody diarrhea, followed by abdominal pain. In patients with amoeba colitis, inflammatory changes in the left colon(rectum, sigmoid colon and descending colon) are the most common. Fecal microscopic examination combined with colonoscopy can improve the clinical diagnosis rate of amoeba colitis. There was no significant difference in sex, age, inflammatory parameters(hypersensitive C-reactive protein, erythrocyte sedimentation rate), prognosis and hospitalization days between IBD group and non-IBD group in amoebic colitis.
作者
侯强
宋正己
HOU Qiang;SONG Zheng-ji(Department of Clinical Medical School of Dali University,Dali,Yunnan 671000,China;Department of Digestive,First People's Hospital,Kunming,Yunnan 650032,China)
出处
《中国热带医学》
CAS
2022年第3期218-223,共6页
China Tropical Medicine
基金
国家自然科学基金(No.81760110)。
关键词
溶组织阿米巴
阿米巴肠炎
炎症性肠病
临床特点
Histolytic amoeba
amoebic colitis
inflammatory bowel disease
clinical features