溃疡性结肠炎与血小板的相关性探讨

目的 调查活动期溃疡性结肠炎患者外周血血小板功能,以期了解溃疡性结肠炎与血小板的关系. 方法 调查67例活动期溃疡性结肠炎患者和80例正常对照者,检测每组人群的外周血中血小板 (PLT)计数、血小板平均容积(MPV)和血小板分布宽度(PDW) .结果 活动期溃疡性结肠炎患者PLT明显高于对照组,而MPV和 PDW则明显低于对照组(P＜0.05).结论 血小板的活化可能在UC患者的活动期参与了重要作用,而且可能与 UC的发病或其并发症的产生有重要联系.     

溃疡性结肠炎与血小板的相关性探讨

目的调查活动期溃疡性结肠炎患者外周血血小板功能,以期了解溃疡性结肠炎与血小板的关系。方法调查67例活动期溃疡性结肠炎患者和80例正常对照者,检测每组人群的外周血中血小板（PLT）计数、血小板平均容积（MPV）和血小板分布宽度（PDW）。结果活动期溃疡性结肠炎患者PLT明显高于对照组,而MPV和PDw则明显低于对照组（P〈0．05）。结论血小板的活化可能在uc患者的活动期参与了重要作用,而且可能与UC的发病或其并发症的产生有重要联系。     

Sulfasalazine-induced colitis complicating idiopathic ulcerative colitis.

A diagnosis of idiopathic ulcerative colitis was made in a previously healthy 9-year-old boy. Symptoms persisted despite therapy with sulfasalazine, 50 mg/kg daily, but they eventually responded to treatment with parenteral nutrition and prednisone, 40 mg daily. Metronidazole was also given to eradicate persistent Dientamoeba fragilis from the stools. The symptoms resolved over 3 weeks, and the daily dose of prednisone was tapered. On two subsequent occasions a challenge with sulfasalazine caused an immediate recurrence of loose, blood-streaked stools and of nonspecific histologic features of ulcerative colitis, which resolved when the sulfasalazine was discontinued.     

Carcinoid tumour as a complication of ulcerative colitis.

Patients with long-standing ulcerative colitis have an increased chance of developing a carcinoma of the colon, especially when the inflammatory process involves the entire colon, but no case of a carcinoid tumour of the colon occurring in a patient with ulcerative colitis has been reported.     

Smoking and ulcerative colitis

In a case-control study of smoking and ulcerative colitis patients with the disease were much less likely to smoke than community controls matched for age and sex. The difference was substantial, with an estimated relative risk of 3.8 for non-smoking on current habits, was even larger (6.2) when habits at onset of the disease were examined, and was mainly accounted for by 42 of 55 patients who had given up smoking a mean of eight years before onset. The association could not be explained by confounding by social class. These findings suggest that smoking directly or indirectly confers protection against ulcerative colitis.     

Liver transplantation in a patient with cholangiocarcinoma and ulcerative colitis.

A 39 year-old patient with cholangiocarcinoma and pre-existing ulcerative colitis was successfully treated by orthotopic liver transplantation. He was given low doses of prednisone and azathioprine and survived for more than 9 months, dying with tumour metastases, thrombosis of the inferior vena cava and an intra-abdominal abscess. At autopsy the homograft showed little evidence of rejection. Preoperatively the patient had septicemia. Removal of his liver was difficult. The discrepancy between donor and recipient in size of blood vessels and the presence of two hepatic arteries in the donor caused problems during the vascular anastomoses. During the operation cardiac arrest occurred. Postoperatively there were several medical and surgical problems, including intraperitoneal and gastrointestinal hemorrhage, paralysis of the right dome of the diaphragm, sinus bradycardia, massive diuresis, peroneal nerve palsy, and one major and three minor episodes of rejection, which were reversed by giving pulse doses of methylprednisolone intravenously.     

中性粒细胞∕淋巴细胞比值与溃疡性结肠炎内镜活动度关系的研究

目的 探索中性粒细胞/淋巴细胞比值(neutrophil-lymphcyte ratio,NLR)与溃疡性结肠炎(ulcerative colitis,UC)Mayo内镜下评分的关系。 方法 研究对象为UC患者98例和肠易激综合征(irritable bowel syndrome,IBS)患者59例。比较2组患者及不同分期UC患者NLR差异,以ROC曲线的方法计算NLR最佳临界值及曲线下面积,比较NLR、C反应蛋白(CRP)在预测UC内镜活动度的效率差异。 结果 UC组患者血中NLR明显高于IBS组(2.689 vs. 1.865,P<0.05),活动期高于愈合期(3.375 vs. 1.867,P<0.05);NLR比值与CRP呈正相关(r=0.434,P<0.05);NLR最佳临界值为2.473(灵敏度为71.0%,特异度为75.9%),AUC为0.84;在UC患者中,Mayo ≥ 2时,NLR>2.473的患者占81%,而CRP为阳性者占67%(P=0.121)。 结论 NLR在UC活动期及愈合期的差异具有统计学意义,且与CRP呈正相关,NLR在预测UC患者内镜活动度与CRP无统计学差异。NLR可以作为一个客观、方便、经济的指标监测患者内镜活动性,可为行肠镜筛选的指标之一。      

亲环素A及其自身抗体与溃疡性结肠炎的相关性

目的:探讨血浆和淋巴细胞内亲环素A(CyP A)水平及CyP A自身抗体与溃疡性结肠炎(UC)的关系。方法:用双抗体夹心ELISA法测定67例活动期、49例缓解期UC患者和50名健康体检(正常对照组)者血浆和淋巴细胞内CyP A水平同时用间接ELISA法检测抗CyP A自身抗体,统计分析其间关系。结果:UC活动期患者血浆和淋巴细胞CyP A水平均显著高于正常对照组和缓解期UC患者(P<0.01),但正常对照组与缓解期UC患者差异无统计学意义(P>0.05)。UC活动期患者抗CyPA自身抗体阳性者也显著高于缓解期UC患者及正常对照组(P<0.01)。结论:血浆和淋巴细胞内CyP A升高和抗CyP A自身抗体阳性可反映UC活动性。     

Toxic megacolon in ulcerative colitis: a continuing challenge.

The incidence, predisposing factors, management and outcome of toxic megacolon (TM) has been reviewed in 65 cases of severe ulcerative colitis (UC) and compared in 2 successive 6-year periods before and after January, 1973. Nineteen episodes of TM occurred in 18 patients. Despite a conscious aim towards earlier surgery in recent years this was not achieved, and despite more intensive medical therapy the incidence of TM was unchanged. Emergency operative mortality in UC fell from 36% to 21% but the mortality of TM remained at 30%. The chief cause of death was colonic perforation. Mortality was associated with increased age, longer pre-operative hospital stay and lower levels of serum albumin. These findings reemphasize the need for earlier surgery if TM is to be prevented, but such a policy must result in some unnecessary emergency colectomies.