溃疡性结肠炎与感染性结肠炎临床和病理比较分析

Difference on the clinical and histological features between ulcerative colitis and infectious colitis

目的 比较溃疡性结肠炎 (UC)与感染性结肠炎 (IC)临床表现、内镜及组织学特点等方面的不同。方法 复习 1996～ 2 0 0 1年我院住院的 12 7例UC和 14 3例IC患者的临床资料 ,比较两组患者的临床表现及常规实验室检查指标 ;盲法比较其中 46例UC和 42例IC患者内镜及组织学表现。结果 两组患者的病程、起病方式、有无血便、诱因、腹痛、恶心呕吐、发热等比较差异有显著性 (P <0 .0 0 1)。血白细胞计数及血色素比较差异有显著性 (P <0 .0 0 1)。内镜表现中提示UC的指标为弥漫性分布、粗糙颗粒变、自发性出血、袋囊变浅、肠管短缩及息肉。提示IC的指标为病变呈灶性分布。组织学表现中弥漫性混合性或慢性固有层炎症、隐窝扭曲与分叉、隐窝萎缩、绒毛状表面、基底浆细胞增多有助于UC的诊断。

Objective To elucidates the differences between ulcerative colitis(UC) and infectious colitis(IC) on clinical, endoscopic and histological features.Methods The clinical,laboratory features in 127 patients with UC and 143 with IC diagnosed in West China Hospital,Sichuan University from 1996 to 2001 were compared.The coloscopic and histological features in 46 UC patients and 42 IC patients were compared and retrospectively analyzed.Results There were significant differences in clinical and laboratory parameters such as clinical course,mode of onset, bloody and pus stools,precipitating factors,abdominal pain,vomiting,fever,white blood count and hemoglobin between two groups(P<0.001).The endoscopic findings in favor of UC consisted of diffuse distribution,granularity,spontaneous bleeding,blunted vesica and pseudopolyps.Patchy distribution was suggestive for IC.There were several histological features indicative of UC,including diffusely mixed or chronic inflammatory infiltration in lamina propria,crypt distorted and branched,crypt atrophy,villiform surface,basal plasmacytosis and so on.Conclusions Endoscopic and histological features have good values in differentiation of UC and IC.