老年溃疡性结肠炎患者的临床和内镜分析-第三军医大学学报.docVIP

老年溃疡性结肠炎患者的临床、内镜和病理分析 项 平，周 鋆，方 颖，季大年（上海复旦大学附属华东医院消化内镜中心，上海 200040） E-mail:zhoujun10000@126.com 摘 要： 目的 探讨老年溃疡性结肠炎患者的临床、内镜和病理特点及与非老年患者的差异。方法 收集分析2000年1月至2008年12月在我院诊断为溃疡性结肠炎患者的相关资料，对老年（≥60岁）溃疡性结肠炎患者与非老年（＜60岁）溃疡性结肠炎患者的临床表现、内镜和病理特点进行比较分析。结果 共收集349例患者，其中老年组68例，男性37例，女性31例，年龄（68.54±7.16）岁；非老年组281例，男性150例，女性131例，年龄（42.38±10.88）岁。老年溃疡性结肠炎患者中腹泻、腹痛和便血等临床表现的发生率与非老年患者均无显著性差异（P＞0.05）。老年组病情轻度患者占60.3%，较非老年组多（P＜0.05）。内镜下老年组溃疡性结肠炎病变范围以直肠、直乙状结肠及左半结肠多见，但与非老年组相比差异无统计学意义（P＞0.05）。在病理学上老年组异型增生的发生率显著高于非老年组（P＜0.05）。结论 老年溃疡性结肠炎患者的病情相对较轻，但异型增生发生率较高，应加以重视。 关键词：老年；溃疡性结肠炎；临床表现；结肠镜检查；病理 中图法分类号： 文献标识码：A Analysis of the clinical, endoscopic and pathological features between the elderly and patients with ulcerative colitis XIANG Ping, ZHOU Jun, Fang Yin, JI Da-nian (Digestive Endoscopy Center, Huadong Hospital, Fudan University, Shanghai 200040, China) Abstract： Objective To analyze the clinical, endoscopic and pathological features of elderly patients with ulcerative colitis, and the difference between elderly and young patients. Methods All patients diagnosed as ulcerative colitis in Huadong Hospital from January 2000 to December 2008 were reviewed. The patients were divided into two groups: elderly group (≥60 years) and young group (＜60 years). The data of clinic, endoscopy and pathology were collected and analyzed. Results 349 patients were included in this study. 68 patients were classified as elderly group, the ratio of male to female was 1.19︰1, and the mean age was 68.54±7.16 years old. 281 patients were classified as young group, the ratio of male to female was 1.15︰1, and the mean age was 42.38±10.88 years old. There were no significant differences in the incidence of diarrhea, celialgia and hemafecia etc. clinical manifestations (P＞0.05) between two groups. The disease of elderly patients was less severe than that of the young patients (P＜0.05). The lesions of the elderly patients were more located at the rectum, sigmoid colon and left hemicolon, but no significant dif