鉴别克罗恩病与溃疡性结肠炎的列线图预测模型构建

目的 探讨鉴别克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC)的独立危险因素并构建列线图预测模型.方法 回顾性分析429例炎症性肠病(inflammatory bowel disease,IBD)的临床病理资料,通过单因素和多因素分析鉴别CD和UC的危险因素并...     

原发性硬化性胆管炎自身抗体检测的临床意义

目的探讨自身抗体检测对诊断原发性硬化性胆管炎(PSC)患者的临床意义。方法采用间接免疫荧光法(IIF)检测抗核抗体(ANA)和抗中性粒细胞胞质抗体(ANCA)并对其结果进行回顾性分析。结果 PSC检测ANA、ANCA、c-ANCA和p-ANCA结果与对照组比较P<0.01,p-ANCA与c-ANCA组间比较P<0.01,差异有非常显著性意义。PSC患者与病毒性肝炎比较,除HCV以外,经χ2检验,P<0.01差异均有非常显著性意义。结论血清ANCA、p-ANCA抗体检测对诊断PSC有着重要作用。对提高PSC在临床上同其它肝病鉴别诊断亦非常重要。     

溃疡性结肠炎相关癌的回顾性探讨

目的 通过对565例溃疡性结肠炎患者进行癌变风险分析,为溃疡性结肠炎相关癌（UC-CRC）的早期筛查及预防提供依据.方法 对收治的565例溃疡性结肠炎患者进行分组,其中15例UC-CRC组患者,随机抽取28例溃疡性结肠炎组患者,对两组临床相关资料进行回顾性分析.结果 在565例溃疡性结肠炎患者中,UC-CRC组患者有15例,总体风险为3.77％.两组患者在年龄、病变内镜活检、疾病病程、血清CRP水平等方面差异有统计学意义（P ＜0.05,P＜0.01）.高危风险因素显示：疾病病程、病变范围、血清CRP水平、病理诊断为UC-CRC的高危因素.结论 溃疡性结肠炎患者中有较高的UC-CRC癌变风险,溃疡性结肠炎的疾病病程、血清CRP水平、内镜活检为不典型增生及程度与UC-CRC的发生呈正相关.     

原发性硬化性胆管炎发病机制的研究进展

原发性硬化性胆管炎（Primary sclerosing cholangitis，PSC）最早于1924年由法国学者Delbet提出，是以肝内外胆管进行性炎症、阻塞和纤维化为特征的慢性胆汁淤积性肝病。其自然发病过程个体差异比较大，典型的症状是黄疸和瘙痒症，其他非特异性症状有腹部不适、乏力、体重减轻等。病情呈进行性发展，最终出现肝硬化和肝衰竭，8％～30％的病人可发展为胆管癌，平均生存时间为12～17年。     

溃疡性结肠炎56例临床分析

目的总结溃疡性结肠炎（UC）的临床特点,疗效及转归。方法回顾性地对1996年1月-2008年12月56例UC患者进行临床分析。结果56例溃疡性结肠炎,病变侵犯直肠7例（12．5徇,直肠乙状结肠12例（21．43%）,左半结肠6例（10．71%）,右半结肠1例（1．79%）,全结肠30例（53．57％）。轻型18例（32．14％）,中型24例（42．86％）,重型14例（25％）。结论本组患者以轻中型为主,内科疗效较好,部分中重型患者需要使用激素和免疫抑制剂治疗。     

Notch4在溃疡性结肠炎中的表达与分析

目的研究Notch4在溃疡性结肠炎(ulcerative colitis,UC)中的表达、分布及意义。方法收集50例UC患者病变部结肠组织及32例结肠癌患者术后大体标本两端的正常黏膜组织。用免疫组化方法检测Notch4在50例UC及32例对照结肠黏膜组织中的表达情况。结果Notch4在UC患者结肠组织及对照的正常结肠组织中均有表达,两者之间的差异无统计学意义(P>0.05)。Notch4的表达与UC患者的性别、年龄及UC病变程度无统计学意义(P>0.05)。结论Notch4在UC患者结肠黏膜组织与正常结肠黏膜组织中的表达相似,差异无统计学意义。     

IgG4相关性硬化性胆管炎的延迟诊断1例

患者男性,75岁。因双下肢浮肿5个月,加重伴腹胀1个月余,于2018年11月6日入院。患者有糖尿病10余年,2012年因黄疸住院,PET-CT示胆总管上段占位性病变,考虑胆管癌,遂在全麻下行肝胆管肿块切除+胆囊切除+肝方叶Ⅳ段切除+胆肠内引流术。     

溃疡性结肠炎相关的分子生物学研究进展

溃疡性结肠炎(ulcerative colitis,UC)是一种以腹痛、腹泻及黏液脓血便为典型临床表现的慢性肠道疾病,其病灶呈连续性弥漫性分布,主要累及结肠的黏膜及黏膜下层.据流行病学统计,UC的发病率呈逐步增高的趋势,而其病因及发病机制尚未完全明确,目前认为是多元化因素综合作用的结果.本文就与UC相关的基因、细胞因子以及相关受体的研究进展作一综述.     

溃疡性结肠炎患者的人格特质、心理健康状况和应对方式

目的:分析溃疡性结肠炎患者的人格特质、心理健康状况和应对方式。方法:选取2014年2月至2016年9月于我院就诊的溃疡性结肠炎患者共150例作为调查组,选取体检健康者150例作为对照组,采用艾森克人格简式问卷、症状自评量表(SCL-90)、医用应对问卷(MCMQ)对患者进行评估,以了解溃疡性结肠炎患者的人格特质、心理健康状况和应对方式分析。结果:调查组患者的心理变态量表评分显著高于对照组,差异具有统计学意义(t=6.403,P0.01),调查组患者的总均分(t=7.406,P0.01)、躯体化(t=9.130,P0.01)、强迫症状(t=8.408,P=0.01)、抑郁(t=7.176,P0.01)、焦虑(t=8.128,P0.01)、恐怖(t=9.886,P0.01)和精神病性(t=4.737,P0.01)均显著高于对照组,差异均具有统计学意义,应对方式评分中,回避评分比较调查组显著低于对照组,差异具有统计学意义(t=4.374,P0.01)。结论:溃疡性结肠炎患者心理变态的人格评分,躯体化、强迫症状、抑郁、焦虑、恐怖和精神病性的心理健康评分与健康人有差异,其主要采取回避的应对方式。     

原发性胆汁性胆管炎抗体及肝外疾病研究

原发性胆汁性胆管炎（PBC）是一种以胆汁淤积为特点的慢性自身免疫性肝病,可发展至肝硬化甚至肝衰竭,早期诊断PBC十分重要。PBC患者多数合并自身免疫性相关肝外疾病,包括干燥综合征、系统性硬化症、甲状腺疾病等。本文总结了PBC相关抗体及相关肝外疾病的研究,帮助临床医生对PBC的诊断及治疗。     

溃疡性结肠炎患者外周血淋巴细胞亚群检测的临床价值

目的 探究外周血淋巴细胞亚群检测在溃疡性结肠炎（ulcerative colitis,UC）诊断中的临床价值.方法 随机选择解放军总医院第一附属医院2011年1月至2013年12月溃疡性结肠炎确诊患者70例,健康体检人群39人,检测其外周血CD3、CD4、CD8、CD4/CD8四项免疫学指标.以SPSS16.0进行独立样本t检验,分析各项指标的诊断价值.结果 溃疡性结肠炎患者与健康人群相比,CD3、CD8差别不明显,CD4、CD4/CD8具有明显差别（P＜0.05）.结论 淋巴细胞亚群的检测对溃疡性结肠炎实验室诊断具有重要临床价值.     

Managing Ulcerative Colitis by Increasing Hydrogen Production Via Oral Administration of Acarbose

The objective of the study was to investigate ulcerative colitis management through oral administration of acarbose. Acarbose has gained importance as a drug used widely to treat Diabetes Mellitus Type 2,as it acts on the small intestine by competitively inhibiting enzymes that delay the release of glucose from complex carbohydrates, thereby specifically reducing postprandial glucose excursion. The main side-effect of treatment with Acarbose, flatulence, occurs when undigested carbohydrates are fermented by colonic bacteria, resulting in considerable amounts of hydrogen. We found that the enteric benefits of Acarbose are partly due to be their ability to neutralise oxidative stress via increased production of H₂ in the gastrointestinal tract. Therefore, some symptoms of ulcerative colitis in human beings can be ameliorated by Acarbose.     

Reduced Plasma Levels of sCD14 and I-FABP in HIV-infected Patients with Mesalazine-treated Ulcerative Colitis

Background: Microbial translocation (MT) is a shared feature of HIV infection and inflammatory bowel disease (IBD). Aims: This study was conducted to assess the impact of IBD (and particularly ulcerative colitis, UC) on plasma markers of MT and immune activation in HIV+ subjects.

Methods: A cross-sectional study was conducted in 3 groups of patients: HIV+/UC+(group HIV/UC); HIV+/UC- (group HIV); HIV-/UC+(group UC). Plasma levels of soluble CD14 (sCD14), intestinal fatty acid-binding protein (I-FABP), and endotoxin core antibodies (endoCAB) were measured as plasma markers of MT. Inflammation and immune activation were evaluated by measuring plasma levels of IL-6, IL-21, TNF-alpha, and high-sensitivity C-reactive protein (hs-CRP). T- and B-cells subpopulations were characterized by FACS analysis.

Results: Seven patients were enrolled in group HIV/UC, 9 in HIV, and 10 in UC. All HIV-positive patients had plasma values of HIV-1 RNA < 37 copies/mL for at least 12 months and good immunological recovery. All patients with UC were treated with oral mesalazine. Markers of MT, immune activation, and inflammation were not increased in subjects with HIV/UC. In fact, they had lower levels of I-FABP (p = 0.001) and sCD14 (p = 0.007) when compared to other patients groups. Positive correlations were found between I-FABP and sCD14 (r = .355, p = 0.076). Frequency of T- and B-cell subsets did not differ among groups.

Conclusions: Our results suggest that UC does not worsen MT, inflammation, or immune activation in HIV-infected subjects. The anti-inflammatory activity of chronic mesalazine administration on intestinal mucosa may contribute to this finding.     

Infliximab Therapy for Children with Moderate to Severe Ulcerative Colitis: A Step-Up versus a Top-Down Strategy

PurposeWe aimed to investigate clinical outcomes between top-down (TD) and conventional step-up (SU) therapies in pediatric patients with moderate to severe ulcerative colitis (UC).Materials and MethodsAll patients underwent clinical and endoscopic evaluation at diagnosis and 4 months and 1 year after treatment. Patients who started treatment with corticosteroid were grouped in the SU group, while those that initiated early infliximab (IFX) were grouped in the TD group. Among the SU group, patients who eventually changed to IFX treatment due to steroid resistance or dependency were included in the SU(R) group.ResultsIn total, 44 children with moderate to severe UC were included for analysis. Twenty-one patients were included in the SU group, 23 were included in the TD group, and 10 were enrolled in the SU(R) group. Relapse rates were 47.6% (10/21) in the SU group and 17.4% (4/23) in the TD group (p=0.033). Among relapsed patients, the durations from remission to relapse were 17.3 months (0.9–46.9) in the SU group and 24.3 months (1.8–44.9) in the TD group. There was no statistically significant difference in the sustained durations of remission after IFX administration between the SU(R) and TD groups [3.9 (1.4–6.3) and 2.3 (0.3–5.2) years, respectively (p>0.05)].ConclusionAccording to our study, early use of IFX without corticosteroid treatment for children with moderate to severe UC helps to lower relapse rates. We also found that IFX was a very effective treatment for pediatric UC, with a sustained duration of remission similar between TD and SU(R) groups.     

穴位埋线疗法联合口服美沙拉嗪治疗溃疡性结肠炎的 护理分析

目的 分析探讨护理干预对穴位埋线疗法联合口服美沙拉嗪治疗溃疡性结肠炎患者的作用。 方法 选取我院2010年8月～2013年3月诊治的位于UC缓解期1周的患者62例,随机分为美沙拉嗪组32例与美沙拉嗪联合穴位埋线治疗组(30例)联合治疗组(30例)采用穴位埋线疗法并予美沙拉嗪口服,同时给予实施综合护理干预。观察美沙拉嗪组及联合治疗组12个月后的缓解时长、复发率以及不良反应情况。结果 美沙拉嗪组、联合治疗组复发率分别为13（40.6％）、5（16.7％）,两组相比较P<0．05;联合治疗组的缓解时间(260±67) d比美沙拉嗪组的缓解时间(219±77) d相对较长,差异有统计学意义（P<0．05）。结论 护理干预对穴位埋线疗法同时使用美沙拉嗪来治疗溃疡性结肠炎有积极意义,有利于减少病情复发,提高患者的生活质量。     

溃疡性结肠炎患者血清NGAL检测及意义

目的 探讨溃疡性结肠炎(UC)患者血液中NGAL的含量和意义.方法 使用胶乳增强免疫比浊法检测89例UC患者血清中NGAL含量并与对照组比较.分析NGAL水平与UC患者WBC数量、PLT数量、CRP和Hgb、HCT、ESR、年龄、疾病活动程度(DAI)关系.结果 UC患者血清中NGAL水平显著高于健康对照组,中位数分别为112ng/mL和48.2ng/mL,差异有统计学意义(P ＜0.0001).血清NGAL水平在轻度和中、重度UC患者血清NGAL中位数分别为78.2ng/mL和67.2ng/mL,差异有统计学意义(t=3.981,P=0.006).UC患者血清NGAL水平与WBC数量、PLT数量、CRP和Hgb、HCT、ESR、年龄无关(P＞0.05),与疾病活动程度(DAI)轻度相关(r=0.525,P＜0.0001).结论 溃疡性结肠炎患者血清NGAL水平升高,升高水平与疾病活动程度有关,但是其在疾病中的作用尚需进一步研究.