炎症性肠病的肠外表现及其临床意义

目的分析并探讨炎症性肠病(IBD)患者肠外表现的特点和临床意义。方法收集、整理并记录251例IBD患者的临床资料,对比溃疡性结肠炎(UC)和克罗恩病(CD)患者出现肠外表现的情况。结果251例患者中,共61例(24.3%)有肠外表现。174例UC者中有肠外表现38例(21.8%),77例CD患者中有肠外表现23例(29.9%)(P>0.05)。UC患者左半结肠型肠外发生率与直肠型比较有显著性差异(P<0.05);CD患者回结肠型和回盲部小肠型分别与单纯结肠型比较,均无显著性差异(P>0.05)。两组患者肠外表现发生率依次为骨关节病变(8.0%、11.7%)、口腔溃疡(4.6%、9.1%)、肝胆(4.0%、6.5%)、皮肤(2.9%、2.6%)、眼部(2.2%、1.3%)、代谢性骨病(0.6%、0),但组间均无显著性差异(P>0.05)。结论UC和CD患者都是以骨关节病变、口腔溃疡、肝胆表现居多,但单纯依据肠外表现情况来区分UC和CD意义可能不大,肠外表现和IBD的炎症累及部位之间的关系还需进一步研究确定。

Characteristics and Roles of Extra-Intestinal Manifestations of Inflammatory Bowel Disease

Objective To analyze and examine the characteristics and roles of extra-intestinal manifestations accompanied with inflammatory bowel disease(IBD) . Methods To retrospectively collect, record and compile clinical data of a total of 251 IBD patients, and compare them with 174 patients with ulcerative colitis (UC) and 77 patients with Crohn's disease (CD) in the extra-intestinal manifestations. Results Sixty-one patients (24.3%) with IBD had extra-intestinal manifestations, 38 (21.8%) with UC and 23 with CD (29.9%) had extra-intestinal manifestations, and no statistical differences were found between them (P>0.05). Compared with rectum-restricted colitis group, the left-side-predominant colitis group in patients with UC were associated with more extra-intestinal manifestations (P<0.05).And compared with the colon-restricted type, the colon-ileum type and ileocecum type in patients with CD were associated with less extra-intestinal manifestations (P>0.05). Osteoarthropathy ranked top among all the extra-intestinal manifestations in both UC and CD patients, with the prevalence rate of 8.0% and 11.7%, respectively (P>0.05). Oral ulcer ranked second (4.6 vs 9.1, P>0.05),and hepatobiliary disease third(4.0% vs 6.5%, P>0.05). Conclusion Osteoarthropathy, oral ulcer and hepatobiliary disease are predominant both in UC and CD patients. It may have little significance to distinguish UC and CD only by extra-intestinal manifestations. The relationship between extra-intestinal manifestations and the scope of inflammation involved should be further confirmed through much larger samples of patients.