182例大肠黑变病患者临床特点的回顾性分析

Retrospective Analysis of Clinical Characteristics of 182 Patients with Melanosis Coli

目的:探讨大肠黑变病患者的内镜检查情况及临床特征。方法:回顾性分析2013年1月—2021年1月于北京市昌平区中西医结合医院进行内镜检查并确诊为大肠黑变病患者的一般资料及内镜特点。结果:5 540例结肠镜检查患者中检出大肠黑变病182例,检出率为3.3%,>45岁患者约占86.3%,女性大肠黑变病检出率高于男性,结肠镜下病变程度以Ⅰ度为主。女性患者病变程度为Ⅰ度的比例高于男性,差异有统计学意义(P<0.05)。大肠黑变病患者合并大肠息肉率高于非大肠黑变病患者,差异有统计学意义(P=0.00)。女性患者合并大肠息肉率低于男性,差异有统计学意义(P=0.018)。发病部位以累及全段大肠多见,且多为腺瘤样息肉。结论:大肠黑变病是一种可逆性疾病,其发生与服用蒽醌类药物相关,中老年人群好发,女性发病率高于男性,且发病较早。大肠黑变病患者容易合并大肠息肉,故在临床工作中,对于重点人群建议行结肠镜检查,同时对已确诊为大肠黑变病的患者,应及时调整临床用药,避免使用含有蒽醌类物质的药物,定期复查肠镜。

Objective:To investigate the endoscopic examination and clinical characteristics of melanosis coli patients.Methods:A retrospective analysis was performed on the general data and endoscopic characteristics of 182 patients diagnosed with melanosis coli by the endoscopy in Beijing Changping District Hospital of Integrated Traditional Chinese and Western Medicine from January 2013 to January 2021.Results:Among 5540 patients detected by colonoscopy,melanosis coli were detected in 182 cases,with a detection rate of 3.3%,and patients aged>45 years accounted for about 86.3%.The detection rate of melanosis coli in women was higher than that in men,and the degree of colonoscopic lesions was mainly grade I.The proportion of female patients with grade I lesion was higher than that in male patients,and the difference was statistically significant(P<0.05).The incidence of colorectal polyps in patients with melanosis coli was higher than that in patients without melanosis coli,and the difference was statistically significant(P=0.00).The incidence of colorectal polyps in female patients was lower than that in male patients,and the difference was statistically significant(P=0.018).The lesion mainly involved the entire large intestine,and most of them were adenomatous polyps.Conclusion:Melanosis coliis is a reversible disease and its occurrence is mainly related to the administration of anthraquinone drug.It is prevalent among middle-aged and elderly people;the incidence in women is higher than that in men,with early onset.Melanosis coli patients are prone to complicating with colonic polyps.Therefore,in clinical work,colonoscopy is recommended for key populations,and for patients diagnosed with melanosis coli,clinical medication should be adjusted in time,drugs containing anthraquinones should be avoided,and regular colonoscopy reviews should be performed.