溃疡性结肠炎与感染性结肠炎综合积分的研究

目的：比较溃疡性结肠炎(UC)与感染性结肠炎(IC)在临床、内镜及组织学等方面的不同，为鉴别UC和IC提供量化的综合鉴别指标，建立积分标准。方法：将1996-2001年在四川大学华西医院住院诊断明确的127例UC和143例IC患者作为研究对象，建立鉴别UC与IC的积分系统。结果：临床积分标准(包括实验室检查)ROC曲线下面积0．990，Youden指数0．903，敏感性为94．5％，特异性为95．8％。组织学表现积分各值分别为0．978、0．864、93．5％和92．9％。临床和内镜综合积分各值分别为0．997、0．954、97．8％、和97．6％。临床、内镜及组织学综合积分各值分别为0．999、0．976、100％和97．6％。结论：通过量化UC和IC临床表现、实验室检查、内镜、组织学等各项有鉴别意义的指标而建立的UC积分诊断标准具有良好的诊断价值。

A score system of differentiation between ulcerative colitis and infectious colitis

Objective To elucidate the differences between ulcerative colitis (UC) and infectious colitis (IC) on clinical,endoscopic,microbiological,histological features and pathological manifestations,and establish a score system based on the measuring these features for the differentiating purpose.Methods The clinical and laboratory features in 127 patients of UC and 143 patients of IC diagnosed in our hospital from 1996 to 2001 were compared.The colonoscopic and histological features in 46 UC and 42 IC patients were compared and prospectively analyzed,a score system to differentiate UC and IC was established.Results ROC area,Youden index,sensitivity and specificity of clinical score (including laboratory tests) were 0.990,0.903,94.5% and 95.8%,respectively.Of histological score were 0.978,0.864,93.5% and 92.9%.Of the score combining clinical and endoscopic features were 0.997,0.954,97.8% and 97.6%.Of the score combining with clinical,endoscopic and histological features were 0.999,0.976,100% and 97.6%.Conclusion The score system based on clinical,laboratory,endoscopic and histological features of UC and IC patients has a good value in differentiation of UC and IC.