溃疡性结肠炎208例诊治分析

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目的回顾性调查近5年郑州大学第一附属医院溃疡性结肠炎(UC)患者的发病状况及5-ASA制剂的疗效。方法调查2005年1月至2010年3月208例住院UC患者。观察UC发病率、年龄、性别、职业、临床表现、结肠镜和组织病理学检查、治疗药物及疗效进行分析。结果 UC住院患者近5年发病率呈上升趋势;平均年龄为(45.25±16.30)岁,发病高峰在40~49岁;男女比例:1.29∶1;临床表现以腹泻(92%)、血便(86%)、黏液便(71%)、腹痛(70%)表现为主;病变范围:以全结肠炎(45%)为主;病程以1~5年为主;住院患者接受结肠镜检查占80.2%,缓解期进行结肠镜检查占11.7%;使用5-ASA制剂治疗占93.5%;急性期平均服药时间(4.06±1.43)周;急性期服用5-ASA剂量以2~3g为主,占69.9%;缓解期服药时间与维持缓解时间呈正相关;缓解期服用5-ASA剂量:以大于2g为主,占69.2%;服药依从性与维持缓解呈正相关;6个月内复发者占51.48%。结论近5年住院UC患者呈上升趋势,5-ASA是维持治疗的有效药物,其有效剂量应大于2g/d,缓解期与维持治疗时间呈正相关,应大于6m。良好的服药依从性能明显延长缓解期,减少复发。 Objective To retrospectively investigate the incidence of ulcerative colitis (UC) in the First Affiliated Hospital of Zhengzhou University in the recent 5 years and the curative effect of 5-ASA preparation. Methods A total of 208 hospitalized UC patients from January 2005 to March 2010 were surveyed. The incidence of UC, age, gender, occupation, clinical manifestations, colonoscopy and histopathology were examined. The therapeutic drugs and the curative effect were analyzed. Results The incidence of UC inpatients showed an upward trend in the recent 5 years. The mean age was (45.25 ± 16.30) years old and the peak incidence was 40-49 years old. The ratio of male to female was 1.29:1. Clinical manifestations included diarrhea (92%), %), Mucus (71%) and abdominal pain (70%). The extent of the disease was mainly total colitis (45%), and the course of disease was mainly 1 to 5 years. The colonoscopy in hospitalized patients accounted for 80.2 %, Colonoscopy in remission accounted for 11.7%; treatment with 5-ASA accounted for 93.5%; acute phase average medication time (4.06 ± 1.43) weeks; acute 5-ASA dosage 2 ~ 3g, accounting for 69.9 %. The time of taking drug in remission period was positively correlated with the duration of remission. The dosage of 5-ASA in remission period was more than 2g, accounting for 69.2%. The medication compliance was positively correlated with maintaining remission. The recurrence rate was 51.48% in 6 months. CONCLUSIONS: The 5-ASA is an effective drug for maintenance treatment. The effective dose of 5-ASA should be more than 2g / d. The remission period is positively correlated with the duration of maintenance treatment and should be greater than 6m. Good medication compliance significantly prolonged remission, reduce recurrence.
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