【摘要】 目的探讨炎症性肠病(Inflammatoryboweldisease,IBD)的临床特点。方法回顾性分析我院14年来确诊的IBD住院病人250例。结果161例溃疡性结肠炎(Ulcerativecolitis,UC)及89例克罗恩病(Crohn’sdisease,CD)中,均男多于女(1.3～1.9:1),各年龄段均有发病,发病高峰为20～50岁。1%CD有阳性家族史。70%～80%UC患者有腹痛、腹泻、血便和黏液便;UC病变范围分型为直肠炎27例(18%),直肠乙状结肠炎40例(26%),左半结肠炎29例(19%),全结肠炎52例(34%),区域性结肠炎4例(3%);病情轻、中、重度分别为67例(42%)、59例(37%)、35例(21%);临床类型为暴发型5例(3%),初发型68例(42%),慢性持续型35例(22%),慢性复发型53例(33%)。58%～80%CD患者有腹痛腹泻,28%CD病人有血便;CD病变范围分型为小肠型28例(31%)、结肠型30例(34%)、回结肠型27例(30%)、其他(食道、十二指肠)4例(5%);病情轻、中、重度分别为15例(17%)、28例(31%)、46例(52%);疾病表型为非狭窄非穿孔型25例(28%),狭窄型33例(37%),穿孔型31例(35%)。肠外表现多累及关节、口腔、皮肤和眼,UC及CD发病率分别为2%、0.6%、0、0和6%、5%、5%、1%。CD并发症较多,主要为肠梗阻、瘘管及穿孔。12例(7%)UC病人因内科治疗无效而行手术,42例(47%)CD病人是经手术确诊为CD,其中13例(15%)初诊为“阑尾炎”。结论IBD就诊人数逐年增加。IBD临床表现多样,CD肠外表现及并发症较UC多见,误诊率较高。更多还原

【Abstract】 Objective To study the clinical features of inflammatory bowel disease(IBD).Methords A retrospective analysis was performed in 250 in-patients with IBD diagnosed in past 14 years.Results 161 Ulcerative colitis(UC) and 89 Crohn’s disease(CD) cases were analyzed according to the diagnostic criteria. The male to female ratio was 1.3～1.9 and the peak age on set was 20～50 years. 1% CD had family history. Abdominal pain、diarrhea and bloody stools were the most common symptoms both in UC and CD. 27(18%) of 161 UC were proctitis and 40(26%) were proctosigmoiditis, 29(19%) left-sided colitis, 52(34%) pancolitis, 4(3%) regional colitis. 68(42%) cases of UC had first episode, 53(33%) had chronic relapse and 35(22%) wre of chronic persist type, 5(3%) were of acute fulminant type. Among 89 patients with CD, the location of disease were ileitis 28(31%), colitis 30(34%),ileocolitis 27(30%) and the uncommon lesion including esophagus and duodenum 4(5%). The behaviour of CD were non-stricturing/non-penetrating 25(28%), stricturing 33(37%) and penetrating 31(35%). Extra-intestinal manifestation in IBD were uncommon which usually involved arthrosis and complications were more frequent in CD including ileus、fistula and perforation. 12(7%) patients with UC performed operation and 42(47%) patients with CD were diagnosed surgically. The acute presentation of CD may mimic acute appendicitis.Conclusions The number of IBD cases increased over the past 14 years. Individual presentations difference diversely. Extra-intestinal manifestations and complications are more frequent in CD which result in the high rate of misdiagnosis.更多还原