老年溃疡性结肠炎临床特点分析

[目的]探讨老年溃疡性结肠炎患者的临床特征。[方法]将本院2010-01-2017-10期间收治的溃疡性结肠炎患者142例,根据年龄分为老年组和非老年组。老年组46例,年龄(65.8±5.3)岁;非老年组96例,年龄(46.5±3.2)岁。比较2组患者的临床资料,包括疾病分型、范围、病情严重程度、临床表现及并发症。统计并比较2组患者入院当天的实验室各项指标检测情况,包括:红细胞沉降率(ESR)、血小板(PLT)、白细胞计数(WBC)、血红蛋白(HGB)、凝血酶原时间(PT)、血清白蛋白(ALB)、C反应蛋白(CRP)。统计各组临床药物治疗情况及临床疗效。[结果]老年组患者病变范围较局限,病情较轻。老年组PLT计数超过正常上限患者比率明显高于非老年组(P0.01)。2组临床症状、不良反应及其他实验室检查指标比较差异无统计学意义(P0.05)。老年组使用糖皮质激素的患者比率明显低于非老年组,2组比较差异有统计学意义(P0.01),但2组临床缓解率比较差异无统计学意义(P0.05)。[结论]老年溃疡性结肠炎患者在疾病累及范围、病变严重程度、实验室检查等方面均不同于非老年者,体现了老年溃疡性结肠炎患者自身的疾病特点。     

16例老年溃疡性结肠炎患者的临床特点

目的 探讨60岁及以上老年溃疡性结肠炎患者的临床特点。方法 选取武汉大学中南医院和人民医院1985～2000年间诊断为溃疡性结肠炎的住院患者及部分门诊患者共186例,对其临床特点进行分析,比较老年溃疡性结肠炎患者(≥60岁)与非老年溃疡性结肠炎患者(20～59岁)间是否存在差异。结果 186例溃疡性结肠炎患者中,≥60岁者16例(8.6％)。在老年溃疡性结肠炎患者中,腹痛、腹泻及发热较非老年溃疡性结肠炎患者多见,便血少见,但差异均无显著性(P>0.05);消瘦及贫血则明显多见(P<0.01)。两组患者的肠外表现及并发症的发生率(分别为12.5％和12.5％、12.7％和3％),差异无显著性(P>0.05)。2例老年溃疡性结肠炎患者并发结直肠癌,非老年溃疡性结肠炎患者中亦有2例结肠癌。其癌变率分别为12％和1％,差异有显著性(P<0.05)。老年组中病情轻度占19％,中重度占81％;而非老年组分别为54％和47％,两者差异有显著性(P<0.01)。结论 老年溃疡性结肠炎患者的病情较非老年患者重,癌变率高于非老年患者,可能与溃疡性结肠炎病程长有关。     

老年前期溃疡性结肠炎患者的临床特点分析

流行病学资料表明 ,溃疡性结肠炎 (Ulcerativecolitis ,UC)的好发年龄为 2 0～ 3 0岁 ,60岁以上老年人UC发病率可有第二个高峰〔1〕。近 2 0年来 ,我国UC发病呈上升趋势〔2 ,3〕。然而 ,有关我国老年前期人群 (4 5 5 9岁 )中UC的发病情况及临床特点的报道鲜见。在此 ,我们回顾性分析老年前期UC患者的临床特点。1　材料与方法1 1　研究对象　回顾性收集 1985～ 2 0 0 0年诊断为UC的住院患者及部分门诊患者共 186例 ,老年前期患者 42例。诊断标准参照《UC的诊断及疗效标准》(1993 ) 〔4〕。 186例UC患者中 ,男12 1例 ,女 65例 ,年龄 5…     

武汉地区老年人溃疡性结肠炎的临床特点

目的回顾分析武汉地区老年人群(≥60岁)溃疡性结肠炎的临床特点。方法选取武汉大学中南医院2007年至2011年住院治疗溃疡性结肠炎的患者共237例,对其临床特点、实验室检查结果及结肠镜下表现进行分析。比较老年人溃疡性结肠炎患者(≥60岁)与非老年溃疡性结肠炎患者(<60岁)间是否存在差异。结果 237例溃疡性结肠炎患者中,≥60岁患者38例(16.03%)。在老年溃疡性结肠炎患者中,腹痛、腹泻及发热等表现与非老年患者均无显著性差异(P>0.05)。老年组血便及消瘦发生率高于非老年组,差异具有统计学意义。病变发生部位上,老年患者局限于脾曲以下者94例(47.24%),与非老年组患者存在差异(P=0.036)。按Truelove和Witts UC分度,老年患者重度9例(23.68%),与非老年组差异存在统计学意义(P=0.007)。老年组使用糖皮质激素者14例(36.84%),与非老年组相比差异具有统计学意义(P=0.116)。结论老年溃疡性结肠炎患者与非老年溃疡性结肠炎患者临床表现、病变范围、病情严重程度及治疗方法等均存在一定差异。     

老年及老年前期溃疡性结肠炎患者临床特点分析

溃疡性结肠炎（UC）在西方国家相当常见，UC患病率最高者可达200人／10^5。国内近年报道逐渐增多，尤其在老年和老年前期患者增多。     

58例老年及老年前期溃疡性结肠炎患者分析

溃疡性结肠炎可发生于任何年龄,一般国外文献认为该病多见于20～40岁[1],对45岁及以上溃疡性结肠炎患者较少关注。本文拟对45岁以上的老年及老年前期溃疡性结肠炎患者的临床特点进行回顾性分析。[第一段]     

新疆地区汉族及维吾尔族溃疡性结肠炎临床特点分析

目的探讨新疆地区汉族和维吾尔族溃疡性结肠炎（UC）患者的发病情况及临床特点的差异。方法回顾分析经临床表现结合电子结肠镜及病理学检查确诊的UC患者699例，其中汉族522例，维吾尔族177例，对比汉族、维吾尔族两组患者的一般资料、年龄分布、临床表现、病变范围、病情严重程度、并发症的发生等的异同。结果维吾尔族组UC结肠镜检出率明显高于汉族组（P〈0．05）。汉族组发病年龄较维吾尔族组发病年龄大（P〈0．05），且汉族组年龄分布广泛。维吾尔族组发热、里急后重及消瘦症状明显（P〈0．05），且慢性持续型和急性爆发型患者明显多于汉族组（P〈0．01）。汉族组与维吾尔族组全结肠炎发病率比较差异有统计学意义（24．71％vs30．51％，P〈0．05）。维吾尔族组中、重度患者明显多于汉族组（76．3％vs47．7％，P〈0．01），并发症发生率明显高于汉族组（18．6％vs6．9％，P〈0．05），UC患者的ANCA阳性率61．5％明显高于汉族组35．5％（P〈0．05）。结论在新疆地区，不同民族UC患者具有不同的发病情况和临床特点。     

老年及老年前期初发型溃疡性结肠炎患者的临床和内镜特点

目的 探讨老年及老年前期初发型溃疡性结肠炎以及中青年初发型溃疡性结肠炎的临床和内镜下特点及治疗效果,以提高对老年初发型溃疡性结肠炎的进一步认识.方法 回顾性分析老年及老年前期与中青年初发型溃疡性结肠炎的发病部位,病变程度,病理表现及治疗缓解情况.结果 老年及老年前期初发型溃疡性结肠炎病变范围以直乙结肠及左半结肠为主,较中青年患者的发生率明显增高;老年及老年前期患者与中青年患者在疾病分度及病理表现上无明显差别.结论 两组应用水杨酸制剂及糖皮质激素治疗的缓解率无明显差别.     

老年溃疡性结肠炎患者临床特点

目的探讨老年溃疡性结肠炎(UC)患者的临床特点。方法收集UC患者完整临床资料,分为老年组21例和中青年组91例,比较两组病情程度、临床表现、镜下及病理表现、病变范围和治疗情况。结果老年组病变以左半结肠及直肠为主;内科治疗无效率明显高于中青年组(P<0.05);甘油三酯(TG)及凝血功能变化较中青年组明显(P<0.05)。老年组发生异型增生明显高于中青年组(P<0.05)。结论老年UC患者疾病活动程度较轻,病变以左半结肠及直肠为主,TG及凝血功能改变明显,癌变率高,内科治疗效果差,并发症多。     

溃疡性结肠炎的内镜特点和临床分析

目的 总结溃疡性结肠炎(UC)的临床特点及内镜下表现。方法 收集1975年至2001年经结肠镜检查及病理确诊的UC患者的相关资料，其中1975—1994年组有486例，1995—2001年组490例，观察其临床特点及内镜表现。确诊靠病理活检。结果 在1975—1994年和1995—2001年两组中，经结肠镜检查确诊的UC患者占同期结肠镜的总数从3．51％上升至4．44％，男女之比分别为1．67和1．25，平均发病年龄从42．4岁上升至51．5岁，高峰年龄段分别是30—49岁和40—49，≥60岁。临床主要表现为黏液脓血便、腹泻、腹痛等，病变范围：直肠及乙状结肠炎占55．4％和64．5％，左半结肠炎占17.3％和13．9％，全结肠炎占11．9％和14．3％。分别有89．9％和90．4％的患者病程小于10年。结论 UC的发病例数有所增加，病变主要以左半结肠为主，病程短，发病年龄相对较大，癌症发生率及并发症低。结肠镜及活检是诊断UC的主要方法。     

Clinical Features of Ileal Pouch Polyps in Patients with Underlying Ulcerative Colitis

Purpose Polypoid lesions rarely occur in the ileal pouch in ulcerative colitis patients after restorative proctocolectomy. Clinical features, malignant potential, and management of pouch polyps have not been characterized. Methods We identified 23 ulcerative colitis patients with large polyps (size≥1 cm) of the ileal pouch from our 2,512-case ulcerative colitis pouch database. Demographic, clinical, endoscopic, and histologic data were reviewed. The Pouchitis Disease Activity Index symptom score (range, 0–6) was used to quantify patients’ symptoms before and after polypectomy. Results Of the 23 patients, 95.7 percent (22 patients) had pouch endoscopy indicated for the evaluation of symptoms when polyps were detected, and 60.9 percent of patients had the polyps in the pouch, 26.1 percent in the anal transitional zone, and 21.7 percent in the afferent limb. The mean size of pouch polyps was 1.9 cm ± 1 cm. Twenty-one patients (91.3 percent) had concomitant pouchitis, cuffitis, or Crohn’s disease. On histology, 21 patients (91.3 percent) had inflammatory-type polyps, and 2 (8.7 percent) had dysplastic or malignant polyps. In 18 patients who had endoscopic polypectomy with concurrent medical therapy, the prepolypectomy and postpolypectomy mean symptom scores were 3.4 ± 1.7 and 1.1 ± 1.2 points, respectively (P = 0.015). Two patients (8.7 percent) had pouch excision for malignancy or for concomitant chronic refractory pouchitis. Conclusions The majority of patients with large ileal pouch polyps were symptomatic. These polyps were typically detected on the background of pouchitis, cuffitis, or Crohn’s disease. Although the majority of polyps were inflammatory type, polyps in two patients were dysplastic or malignant. Endoscopic polypectomy with concomitant medical therapy seemed to improve patients’ symptom scores. Supported in part by a NIH grant R03 DK 067275 and an American College of Gastroenterology Clinical Research Award (to B.S.). Poster presentation at meeting of the American College of Gastroenterology, Honolulu, Hawaii, October 30 to November 2, 2005. Reprints are not available.     

Ulcerative Colitis: Comparison Between Elderly and Young Adult Patients and Between Elderly Patients with Late-Onset and Long-Standing Disease

Background and Aim

We examined the pathologies, treatment characteristics, and clinical course of elderly ulcerative colitis (UC) patients.

Methods

Among 222 UC patients (127 men, 95 women; average age, 34 ± 16 years), we selected 109 with UC diagnosed between 20 and 39 years of age (young adult group) and 23 diagnosed at ≥60 years of age (elderly group). Moreover, 12 patients diagnosed between 60 and 64 years of age (late-onset group) and 6 patients aged ≥60 years diagnosed under 50 years old (long-standing group) were also extracted for sub-analysis. The clinical characteristics and course were compared among the groups.

Results

The average age at onset was 29 ± 6 years in the young adult group and 66 ± 5 years in the elderly group. The frequency of immunomodulator or steroid use did not differ between the two groups. The comorbidity rate was 14.7 % in the young adult group and 69.6 % in the elderly group (P < .0001). Seven patients (58.3 %) in the late-onset UC group and none of the patients in the long-standing UC group were on steroid treatment. None of the patients in the long-standing UC group required hospitalization/surgery for UC exacerbation, while 3 (25.0 %) and 2 patients (16.7 %) in the late-onset group required hospitalization and surgery, respectively.

Conclusions

The comorbidity rate was significantly higher in the elderly group. Treatments did not differ significantly between the young adult and elderly groups. Therefore, it appears that the inflammation tends to subside with age in elderly patients with long-standing UC.     

Appendiceal Involvement in Patients with Ulcerative Colitis

Abstract: There have been few case reports of ulcerative colitis with appendiceal involvement because the appendix has generally received little attention in ulcerative colitis patients. We encountered an inflammatory appendiceal lesion in a patient with ulcerative colitis, which piqued our interest in endoscopic findings of the appendix in these patients. Subsequently, we carefully observed the appendiceal orifice during colonoscopy in patients with ulcerative colitis. From December 1994 to December 1996, 44 patients with ulcerative colitis underwent colonoscopy in Nagaoka Red Cross Hospital. Among these 44, there were three in whom it had not been possible to observe the cecum. During this period, we encountered inflammatory appendiceal lesions in eight cases. Therefore, 20% (8/41) of patients with ulcerative colitis undergoing colonoscopy had appendiceal involvement. Five of these eight patients showed a colonoscopically normal cecum, such that appendiceal involvement thought to be a colonoscopic skip lesion was seen in five (12%: 5/41). There was only one case who had an appendiceal lesion without a microscopically diseased cecum. Appendiceal involvement may be frequent in ulcerative colitis. We thus recommend that endoscopists meticulously examine the appendiceal orifice during colonoscopy in patients with ulcerative colitis.     

喀什地区维吾尔族溃疡性结肠炎临床特征分析

背景:近年来溃疡性结肠炎(UC)的发病率逐年升高,且发病特征具有明显的地域和种族差异。目的:探讨喀什地区维吾尔族(维族)UC的临床特征。方法:纳入2003年2月-2012年2月新疆喀什地区第二人民医院确诊的维族UC患者,对入组患者的一般情况、UC临床类型、疾病严重程度、病变部位、并发症以及治疗情况进行回顾性分析。结果:共126例患者纳入研究。男女比例为1.03∶1(64/62),青年为高发年龄段(48.4%);临床类型以慢性复发型多见(50.0%);疾病严重程度以中重度多见(83.3%);病变部位以左半结肠为多见(45.2%);并发症发生率低(4.8%);治疗以内科药物为主。结论:喀什地区维族UC患者男女性别无明显差异,以青年高发,慢性复发型多见,疾病严重程度以中重度多见,病变部位以左半结肠多见,并发症发生率低,治疗以内科药物为主。     

Acute Pancreatitis in Patients with Ulcerative Colitis

Twenty-two patients (13 men and 9 women; median age, 34 years; range, 15–64 years) with ulcerative colitis (UC) were evaluated to determine the incidence of acute pancreatitis with UC at the First Department of Internal Medicine, Mie University School of Medicine, during 1989–2001. Among these, three patients (14%) were diagnosed as having had episodes of acute pancreatitis during the mean follow-up period of 6 years. One patient presented with acute pancreatitis and UC simultaneously. Two patients had drug-induced pancreatitis (one due to azathioprine and the other due to 5-ASA). In conclusion, acute pancreatitis is not a frequent, but an occasional extraintestinal manifestation of UC.     

缺血性结肠炎与溃疡性结肠炎临床表现及内镜特点的对比分析

目的 比较缺血性结肠炎(IC)与溃疡性结肠炎(UC)临床及内镜表现的差异,研究对两者的鉴别以利对其的诊断和治疗.方法 回顾分析2007年1月～2010年8月诊断为IC 30例和UC 40例患者的资料,重点分析两者在年龄分布、性别构成、病程、基础疾患、临床和内镜表现及病理诊断的异同点.结果 IC组和UC组在年龄分布、病...