炎症性肠病患者脊柱关节炎的表现特点

目的探讨炎症性肠病(IBD)患者的肠外表现—脊柱关节炎的发生情况,为后续炎症性肠病患者的诊断治疗提供借鉴。方法分析2016年9月至2020年9月本院收治的210例炎症性肠病患者(其中溃疡性结肠炎/UC组138人,克罗恩病/CD组72人)肠道病变分布情况,并分析UC组及CD组患者脊柱关节炎各种分型的发生率及两组之间表达的差异。结果UC患者的临床表现以直肠炎,左半结肠炎及全结肠炎为主。CD患者的临床表现以回结肠炎,末端回肠炎及结肠炎为主。IBD患者肠外脊柱关节炎总发生率为UC:20.3%,CD:36.1%;两组中轴型关节炎发病率较低,且在UC与CD患者之间没有差异;外周型关节炎CD组的发生率均高于UC组,差异有统计学意义(P=0.013),外周型发病率由高到低依次为:关节炎,肌腱炎,指/趾炎;本研究中,中轴型+外周型关节炎在UC和CD患者中的发病率相同。结论炎症性肠病患者脊柱关节炎发生率较高,临床医生在诊治过程中应提高对炎症性肠病肠外关节表现的认识,根据患者的临床表现和医学检查结果对患者进行综合诊断,合理地选择治疗方法和药物,有效地提高治疗效果,改善患者的症状。

Features of spondyloarthritis in patients with inflammatory bowel disease

Objective To explore the extraintestinal manifestations of patients with inflammatory bowel disease(IBD)—the occurrence of spondyloarthritis,and to provide reference for the diagnosis and treatment of patients with IBD.Methods Rretrospective analysis of the distribution of intestinal lesions of 210 patients with IBD(138 cases for ulcerative colitis/UC group and 72 cases for Crohn's disease/CD group)in Henan Provincial People's Hospital from September 2016 to September 2019.The incidence of various types of spondyloarthritis in patients with UC and CD,as well as the differences between the two groups were analyzed.Results The main manifestations of patients with UC were proctitis,left semi-colitis and total colitis.The main manifestations of patients with CD were ileocolitis,terminal ileocolitis and colitis.The total incidence of spondyloarthritis in IBD patients was UC:20.3%,CD:36.1%.The incidence of axial spondyloarthritis was low and there was no difference between UC and CD patients.The incidence of peripheral spondyloarthritis in patients with CD was higher than that of UC patients,and the difference was statistically significant(P=0.013).The incidence of arthritis was the highest,followed by tendonitis,and finger/toe inflammation.In this study,the incidence of patients with both axial spondyloarthritis and peripheral spondyloarthritis was the same in patients with UC and CD.Conclusion The incidence of spondyloarthritis in patients with IBD was relatively high.The clinicians should improve their understanding of the spondyloarthritis in the diagnosis and treatment of IBD.With the purpose of improving the treatment effect and the symptoms of patients,they should make a comprehensive diagnosis and give a reasonable treatment according to the clinical manifestations and the medical tests.