溃疡性结肠炎360例临床特征分析

近年溃疡性结肠炎（UC）的发病率明显升高，明确临床特征有助于其诊断。目的：探讨UC的临床特征。方法：收集2008年7月-2011年7月西京医院收治并确诊的活动期UC患者的临床资料，回顾性分析其临床特征。结果：共收治活动期UC患者360例，男女之比1．25：1；平均就诊年龄40．5岁。疾病严重程度以轻中度UC多见（84．4％）。病变累及以左半结肠和直肠、乙状结肠多见；18例病变呈节段性分布，其余均为连续分布。本组患者以腹泻、黏液脓血便、腹痛为主要临床表现，内镜下黏膜弥漫性充血、水肿、糜烂和溃疡，44例伴有肠外表现。多数患者的白细胞、ESR和CRP水平增高。52例患者合并并发症。349例患者接受内科治疗，病情明显缓解。结论：UC患者以中青年男性多见，内镜下病变以左半结肠和直肠、乙状结肠多见，常见并发症为结肠假性息肉。UC确诊主要根据临床表现、结肠镜检查、病理学检查，其中结肠镜检查可明确病变部位、范围、程度以及肠腔有无狭窄或癌变，有助于临床病情分期，对指导临床治疗方案的选择具有重要意义。

Clinical Characteristics of Ulcerative Colitis: Analysis of 360 Cases

Background:The prevalence of ulcerative colitis(UC) has been increasing rapidly in recent years,identifying the clinical characteristics is helpful for its diagnosis.Aims:To investigate the clinical characteristics of UC.Methods: Clinical data of active UC at Xijing Hospital from July 2008 to July 2011 were collected,and clinical characteristics were retrospectively analyzed.Results:A total of 360 patients with UC were enrolled,the ratio of male to female was 1.25:1, the average age at diagnosis was 40.5 years.Mild to moderate UC was found in most patients(84.4%),lesions involving left hemicolon and rectum-sigmoid colon were more common,and almost all patients had continuously distributed lesions except 18 cases with segmental distribution.Diarrhea,purulent stools,abdominal pain were the predominant clinical manifestations,mucosal diffuse hyperemia,edema,erosions and ulcers were seen at endoscopy,and 44 patients had extraintestinal manifestations.White blood cell,ESR and CRP levels were increased in most of all UC patients.Fifty-two patients had complications.The disease was ameliorated in 349 patients after medical treatment.Conclusions:UC are more common in middle-aged men,lesions are mainly located in left hemicolon and rectum-sigmoid colon.Colonic pseudopolyps is one of the common complications.The diagnosis of UC depends on clinical manifestation,colonoscopy and pathology.Colonoscopy is significant for choosing therapeutic regimen in clinical practice,because it can identify the location of lesion,extent and severity of disease,and whether stenosis or carcinomatous change occurred.