摘要
目的探讨老年溃疡性结肠炎（UC）患者与非老年患者临床特点的差异，为老年UC的临床诊治提供经验。方法回顾性分析我院2009年1月至2012年10月收治的204例住院UC患者的临床及内镜资料，通过自建量表建立数据库，以发病60岁作为分组标准，分为老年组（发病年龄≥60岁）和非老年组（发病年龄〈60岁），比较两组在临床表现、实验室检查、内镜检查等方面是否存在差异。结果204例UC患者中，老年患者33例（16．2％，33／204），非老年患者171例（83．8％，171／204），发病高峰年龄为30～39岁。在老年UC患者中，主要临床表现、肠外表现、并发症、临床严重程度及内镜下分级与非老年组比较差异均无统计学意义（P均〉0．05），但腹胀（36．4％与14．6％）、便秘（9．1％与1．2％）、排便困难（6．1％与0．6％）、菌群失调（66．7％与48．0％）、低钾血症（45．5％与14．0％）、低蛋白血症（36．4％与20．5％）与非老年组比较差异均有统计学意义（x。值分别为8．808、7．260、5．724、3．876、17．660、3．942，P均〈0．05）。老年组患者结肠病变范围多局限于脾曲以下，与非老年组相比差异有统计学意义（P=0．044）。结论老年UC患者临床表现及疾病严重程度与非老年患者相似，但病变范围多局限于脾曲以下，易合并低钾血症、低蛋白血症、肠道菌群失调，应予以重视。
Objective To investigate the clinical characteristics between elderly and non-elderly patients with ulcerative colitis （ UC ） in order to provide the base for diagnosis and management of the disease. Methods Two hundred and four patients with UC admitted to Shengjing Hospital from January 2009 to December 2011 were enrolled in this study. The patients were divided into elderly group （ I〉60 years of age） and non-elderly group（ 〈 60 years of age）. The clinical manifestation, laboratory examination indices and endoscopic feature were recorded and analyzed. Results Among the 204 cases with UC ,33 （16. 2% ,33/204） were elderly patients, and 171 （83.8%, 171/204） were non-elderly patients. Onset peak of UC was ranged from 30 - 39 years old. There was no significant difference in terms of other indices of clinical presentations, extraintestinal manifestations, complications, clinical and endoscopic score between two groups. The rate of abdominal distension,＇constipation, difficult defecation, alteration of intestinal flora, hypokalemia and hypoproteinemia in elderly group were 36. 4%, 9. 1%, 6. 1%, 66.7%, 45.5 %, 36.4% respectively, higher than that in in non- elderly group （ 14. 6%, 1.2%, 0. 6%, 48.0%, 14. 0%, 20. 5% respectively ）, and there was significant differences between groups （ x2 = 8. 808,7. 260,5. 724,3. 876, 17. 660 and 3. 942 respectively, P 〈 0.05）. Endoscopic examination revealed that the colonic lesion parts in elderly patients was limited in left-side colon and protosigmoid, which was different from that of no-elderly group （ P = 0. 044）. Conclusion The elderly patients showed a similar clinical manifestation with non-elderly patients. However, the colonic lesion parts in eider group was limited to left-side colon and protosigmoid. They also had the higher rate of hypoproteinemia, hypokalemia and alteration of intestinal flora,which needed to pay more attention.
出处
《中国综合临床》
2014年第1期33-35,共3页
Clinical Medicine of China
基金
沈阳市科学技术计划项目资助（F13-318-142）
