摘要
背景:近年来,随着炎症性肠病(IBD)发病率的增加,其临床和诊治特征发生明显变化。目的:探讨安徽省立医院近10年IBD的临床变迁。方法:收集安徽省立医院2008年1月—2017年11月新诊断IBD患者的住院资料,比较2013年前后收治患者临床特征和诊治方式的差异。结果:共515例IBD患者纳入研究。近5年IBD住院人数增长明显,2017年溃疡性结肠炎(UC)和克罗恩病(CD)住院人数分别是2013年的3.72倍和3倍。2013年前UC主要累及左半结肠(47.8%),以轻中度患者居多(85.3%),2013年后则以广泛结肠病变多见(54.5%),中重度患者比例增高(83.8%)。2013年后,累及回结肠(65.5%)和中重度CD患者(58.6%)比例增高,50.9%的CD患者出现并发症,主要为肛周病变(44.8%)。近5年IBD患者完善结肠镜和活检病理检查者的比例达95%以上,典型病理改变检出率、结合临床表现、结肠镜和活检病理改变综合诊断的比例明显增高,UC患者应用激素和免疫抑制剂治疗、CD患者应用免疫抑制剂、生物制剂、肠内营养治疗增多。结论:近5年安徽省立医院IBD住院患者增长明显,IBD的临床特征和诊治方式随时间推移而发生改变,诊治水平有显著提高。
Background:The clinical characteristics and management approaches of inflammatory bowel disease(IBD)change accordingly with the increasing incidence of the disease.Aims:To investigate the clinical changes of IBD in the last decade(2008-2017)in Anhui Provincial Hospital.Methods:Hospitalization data of patients with newly diagnosed IBD admitted from Jan.2008 to Nov.2017 at the Anhui Provincial Hospital were collected,and then the clinical characteristics and management approaches were compared between Group A(2008-2012)and Group B(2013-2017).Results:A total of 515 IBD cases were enrolled in this study.Hospitalized IBD cases increased significantly from 2013 to 2017.Cases of ulcerative colitis(UC)was 3.72 times and cases of Crohn’s disease(CD)was 3 times in 2017 as that in 2013.In Group A,UC mainly involved the left colon(47.8%),with mild-to-moderate activity(85.3%);while the majority of UC in Group B presented as pancolitis(54.5%),and mostly with moderate-to-severe disease(83.8%).In group B,the proportion of CD involving ileocolon(65.5%)and with moderate-to-severe disease(58.6%)was significantly increased;complications occurred in 50.9%of the CD patients,predominantly the perianal lesions(44.8%).In the past 5 years,colonoscopy and biopsied pathology were more accessible(>95%),and the detection rate of typical pathological changes,as well as the comprehensive diagnosis based on clinical,colonoscopic and pathological findings were significantly increased.In respect of treatment modalities,steroids and immunosuppressants were more frequently used in UC,and immunosuppressants,biological agents and enteral nutrition were more frequently used in CD in the past 5 years.Conclusions:The number of hospitalized IBD patients admitted in Anhui Provincial Hospital increased significantly in the past 5 years.The clinical characteristics and management approaches of IBD changed as time passed.The diagnosis and treatment were significantly improved.
作者
李婷
王巧民
LI Ting;WANG Qiaomin(Department of Gastroenterology,Anhui Provincial Hospital Affiliated to Anhui Medical University,Hefei(230001))
出处
《胃肠病学》
2018年第4期204-208,共5页
Chinese Journal of Gastroenterology
关键词
结肠炎
溃疡性
CROHN病
炎症性肠病
诊断
治疗
Colitis,Ulcerative
Crohn Disease
Inflammatory Bowel Disease
Diagnosis
Therapy
