炎症性肠病10年住院病例临床资料分析

发布时间：2018-09-09 09:07

【摘要】：目的：分析近10年在吉林大学第一医院确诊的IBD住院患者的临床资料，了解近10年IBD住院患者的临床流行病学、临床表现和治疗方案，希望能对我国IBD的流行病学研究提供理论依据，从而提高对IBD的临床认识，以利于该病的诊断和治疗。方法：通过吉林大学第一医院病案室数据库收集2003年1月1日至2012年12月31日吉林大学第一医院确诊的IBD住院患者的临床资料，对其进行回顾性分析。IBD患者按入院时间分为2组：1组=IBD，2003年~2007年；2组=IBD，2008年~2012年。按入院类型把1组、2组分为4个亚组：A1组=UC，2003年~2007年；B1组=CD，2003年~2007年；A2组=UC，2008年~2012年；B2组=CD，2008年~2012年，利用上述分组比较分析患者的临床流行病学、临床特征及治疗方案等的变化趋势。结果：近10年吉林大学第一医院确诊IBD住院患者共458例，男281例，女177例，其中UC共374例，男214例，女160例；CD共84例，，男67例，女17例。A组、B组、A1组、A2组、B1组、B2、1组、2组患者男女之比分别为1.34:1、3.94:1、1.36:1、1.32:1、5.25:1、3.54:1、1.58:1、1.59:1。10年来UC、CD性别相对比无明显变化，但两者之间相比有显著性差异，CD以男性多见。A组、B组、A1组、A2组、B1组、B2组、1组、2组平均诊断年龄分别为44.2±18.1岁、36.0±15.8岁、44.5±16.8岁、44.0±18.7岁、42.3±14.6岁、33.0±15.5岁、44.2±16.5岁、41.6±18.6岁。10年来IBD、UC平均诊断年龄无明显变化，但CD平均诊断年龄逐渐年轻，与UC有明显差异。A组UC中有吸烟史者58例（15.5%）；B组CD中有吸烟史者20例（23.8%）。A组UC有饮酒史者39例（10.4%）；B组CD有饮酒史者6例（7.1%）。10年间UC与CD相比吸烟史、饮酒史无明显差异。A组UC就诊消化科、传染科、中医科较B组CD多；B组CD就诊普外科、儿科较A组UC多；2组IBD入院科室与1组相比变化主要表现为就诊消化科、儿科比例增加，就诊普外科比例减少。IBD的临床表现形式多样，与国内外研究基本相似，但各症状比例低于国内外研究。A组UC肠外表现有13例（3.5%）；B组CD肠外表现有23例（27.4%）。10年间UC和CD相比肠外表现有显著差异，CD肠外表现较常见。A组UC全身表现：低蛋白血症164例（43.9%），体重下降134例（35.8%），贫血130例（34.8%），发热53例（14.2%）；B组CD全身表现：低蛋白血症39例（46.4%），体重下降37例（44.1%），贫血35例（41.7%）、发热15例（17.9%）。10年间UC和CD住院患者全身表现无显著差异，但CD全身表现各症状所占比例较UC大。IBD住院患者处于不同时期，ESR、CRP均有不同程度的改变。A组、B组、A1组、A2组、B1组、B2组、1组、2组接受外科治疗情况分别为28例（7.5%）、16例（19.1%）、16例（10.2%）、12例（5.6%）、7例（28%）、9例（15.3%）、23例（12.6%）、21例（7.6%）。UC及CD治疗均以内科为主，10年来IBD接受外科治疗逐渐减少，CD接受外科治疗较UC多见。结论：1、10年来IBD住院确诊患者总体呈增加趋势，CD的增长尤为显著，其中前5年呈逐渐增加趋势，后5年维持在一定水平。 2、10年来UC、CD的性别相对比和UC、IBD的年龄构成比无明显变化，CD年龄分布逐渐年轻化。 3、CD和UC相比男女性别相对比、年龄构成比、肠外表现，接受内外科治疗的患者构成比有显著差异性，吸烟、饮酒史、全身表现无显著性差异。 4、10年来IBD接受外科治疗逐渐减少，CD接受外科治疗较UC多见。近5年来IBD住院患者的内科治疗中氨基水杨酸类、免疫抑制剂、生物制剂和抗生素应用逐渐增多。
[Abstract]:Objective: To analyze the clinical data of IBD inpatients confirmed in the First Hospital of Jilin University in the past 10 years and to understand the clinical epidemiology, clinical manifestations and treatment plans of IBD inpatients in the past 10 years, so as to provide theoretical basis for the epidemiological study of IBD in China, so as to improve the clinical understanding of IBD, so as to facilitate the diagnosis and treatment of IBD.
Methods: The clinical data of IBD inpatients in the First Hospital of Jilin University from January 1, 2003 to December 31, 2012 were collected and analyzed retrospectively. The patients were divided into 2 groups according to admission time: 1 group = IBD, 2003-2007; 2 group = IBD, 2008-2012. Group A1 = UC, 2003-2007; Group B1 = CD, 2003-2007; Group A2 = UC, 2008-2012; Group B2 = CD, 2008-2012. The clinical epidemiology, clinical characteristics and treatment regimens were compared and analyzed.
Results: In the past 10 years, 458 patients with IBD were diagnosed in the First Hospital of Jilin University, 281 males and 177 females, of whom 374 were UC, 214 males and 160 females, 84 were CD, 67 males and 17 females. There was no significant difference in the sex ratio between the two groups. Group A, group B, group A1, group A2, group B1, group B2, group 1, the average diagnostic ages of the two groups were 44.2 [18.1], 36.0 [15.8], 44.5 [16.8], 44.0 [18.7], 42.3 [14.6], 33.0 [15.5], 44.2 [16.5], 41.6 [18.6], respectively. There were 58 cases (15.5%) of UC in group A, 20 cases (23.8%) of CD in group B, 39 cases (10.4%) of UC in group A and 6 cases (7.1%) of CD in group B. The clinical manifestations of IBD are various, similar to those of domestic and foreign studies, but the proportion of symptoms is lower than that of domestic and foreign studies. The extraintestinal manifestations of UC in group A were 13 cases (3.5%) and 23 cases (27.4%) in group B. The extraintestinal manifestations of UC and CD were significantly different from those of extraintestinal manifestations in 10 years. The general manifestations of UC in group A were hypoproteinemia in 164 cases (43.9%), weight loss in 134 cases (35.8%), anemia in 130 cases (34.8%) and fever in 53 cases (14.2%). There were 37 cases (46.4%), 37 cases (44.1%) of weight loss, 35 cases (41.7%) of anemia, 15 cases (17.9%) of fever. There was no significant difference in general manifestations between UC and CD inpatients in 10 years, but the proportion of all symptoms of CD was larger than that of UC. The medical treatment was 28 cases (7.5%), 16 cases (19.1%), 16 cases (10.2%), 12 cases (5.6%), 7 cases (28%), 9 cases (15.3%), 23 cases (12.6%) and 21 cases (7.6%) respectively.
Conclusion: Over the past 10 years, the number of hospitalized patients with IBD has increased, especially CD. The first five years showed a gradual increase trend, and the last five years maintained a certain level.
The sex ratio of UC, CD and the age composition ratio of UC and IBD have not changed significantly in the past 10 years. The age distribution of CD is gradually younger.
3. There were significant differences between CD and UC in sex, age composition, parenteral manifestations, and the proportion of patients receiving surgical treatment. There were no significant differences in smoking, drinking history and general manifestations.
In the past five years, the use of aminosalicylic acid, immunosuppressive agents, biological agents and antibiotics has increased gradually in IBD inpatients.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R574

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