炎症性肠病患者肝胆胰病变检出情况研究

目的 探讨炎症性肠病(IBD)患者肝胆胰病变的检出率和临床特点.方法 选取本院1990-2010年收治的IBD患者606例[克罗恩病(CD)68例,溃疡性结肠炎(UC)538例],另选取年龄、性别和体质指数(BMI)与IBD组匹配的健康体检者606例(对照组).比较IBD组和对照组肝胆胰病变检出情况,如胆石病、非酒精性脂肪性肝病(NAFLD)、原发性胆汁性肝硬化(PBC)、原发性硬化性胆管炎(PSC)、自身免疫性肝炎(AIH)、慢性胰腺炎(CP)等.按各统计率统计分析比值比(OR)、95%可信区间(95%CI)和P值,P＜0.05为差异有统计学意义.结果 (1)CD组和UC组患者胆石病检出率分别为51.47%(35/68)和34.01%(183/538),与对照组比较CD的OR=10.96[95%CI(4.181,28.724)],UC的OR=5.79[95%CI(4.053,8.264)],与对照组比较差异均有统计学意义(P＜0.01).(2)CD组和UC组患者NAFLD检出率分别为64.71%(44/68)和69.33%(373/538),与对照组比较CD的OR=8.56[95%CI(3.854,18.994)],UC的OR=8.41[95%CI(6.378,11.084)],与对照组比较差异均有统计学意义(P＜0.01).(3)在少见的肝胆胰病变中筛查IBD,检出率分别是:PBC 2.25%(7/311),PSC 4.49%(4/89),AIH 3.33%(2/60),CP 0.93%(2/213).结论 胆石病和NAFLD是IBD最常见的肝外表现,尤其是在CD和UC这两种IBD中检出率均高.建议在IBD和肝胆胰疾病中应进行规范的系统的相互筛查和调查.

Hepatopancreatobiliary Complications among Patients with Inflammatory Bowel Disease

Objective To investigate the frequency and characteristics of hepatopancreatobiliary(HPB) complications among patients with Crohn`s disease(CD) and ulcerative colitis(UC).Methods A total of 606 inflammatory bowel disease(IBD) patients(68 CD,538 UC) treated by our hospital between 1990 and 2010 and 606 healthy subjects matched for age,sex,and body mass index(BMI) were enrolled.Frequency of HPB complications including gallstone disease(GD),nonalcoholic fatty liver disease(NAFLD),primary biliary cirrhosis(PBC)...