目的：回顾性调查昆明市住院的炎症性肠病（IBD）患者，了解该市近年来 IBD 患者临床资料特点。方法选取该市10家三级综合医院，调查2007年1月至2013年12月住院符合 IBD 诊断的1029例患者的性别、年龄、病程、症状等人口资料及诊断、治疗、转归等情况。结果本组资料显示，该市近7年 IBD 住院病例数有逐年上升的趋势。1029例 IBD 患者中溃疡性结肠炎（UC）患者853例，克罗恩病（CD）患者157例，未定型 IBD 患者19例。本组 IBD 患者男女比例为1．23∶1．00，IBD 患者平均发病年龄为（47．93±16．78）岁，UC 患者的发病高峰年龄为40～60岁，CD 患者发病高峰年龄为20～40岁，以病程小于5年的患者居多；本组 IBD 患者城镇人口多于农村人口；UC 住院病例明显多于 CD ，住院 IBD 患者疾病严重程度以中度为主。 UC 临床类型以慢性复发型（64．4％）为主，CD 以狭窄型（41．2％）和炎症型（51．0％）为主。 IBD 主要症状有腹泻（91．0％）、腹痛（84．6％）、血便（79．4％）等；肠外表现（6．1％）和并发症（10．6％）少见。辅助确诊手段主要为结肠镜（97．7％）及病理检测（29．2％）。结肠镜检查显示 UC 以直肠和乙状结肠病变为主，CD 以回盲部及回肠末端为主。治疗以氨基水杨酸类和类固醇激素为主，较少患者应用免疫抑制剂。单纯内科治疗总有效率达92．4％，病死率0．4％。结论该市 IBD 发病数近年有逐渐增加的趋势，发病患者以中青年为主，疾病严重程度以中度为主，UC 临床类型以慢性复发型为主，CD 以狭窄型和炎症型为主，肠外表现及并发症较少。治疗以氨基水杨酸类及类固醇激素为主，并且需要长期维持治疗。%Objective To retrospectively investigate hospitalized patients with inflammatory bowel disease (IBD) in Kun-ming ,to understand their characteristics of clinical data in recent years .Methods Ten three-tertiary general hospitals in Kunming were selected and clinical information of 1 029 patients diagnosed IBD from January 2007 to December 2013 were reviewed ,inclu-ding gender ,age ,course of disease ,symptoms ,diagnosis ,treatment and outcomes .Results This study showed that there was an up-ward tendency of IBD patients in recent 7 years in Kunming .Among the 1 029 IBD patients ,853 patients had ulcerative colitis (UC) ,157 patients had Crohn disease(CD) and 19 patients had undifferentiated IBD .The ratio of male to female was 1 .23 ∶ 1 .00 , and the average onset age of IBD was (47 .93 ± 16 .78)years old .The peak onset age of UC was from 40 to 60 years old ,while CD was more prevalent from 20 to 40 years old .Most of these patients had IBD less than 5 years .Cases from urban areas were more than from the country side .The majority of these hospitalised cases were moderate IBD patients and more UC cases than CD . 64 .4% of the UC cases were chronic and relapsing ;while in the CD cases ,51 .0% were inflammatory and 41 .2% were stenotic type .The main symptoms of IBD were diarrhea (91 .0% ) ,abdominal pain (84 .6% ) ,bloody stool (79 .4% ) and so on .About 6 .1%IBD patients had extraintestinal manifestations and 10 .6% of IBD patients had complications .The auxiliary diagnosis methods were colonoscopy (97 .7% ) and pathology (29 .2% ) .Colonoscopy revealed that UC lesions were in the rectum and sigmoid colon ,and CD lesions were in ileocecal and terminal ileum .Aminosaliccylic acid and steroids were the main medications and immunosupressant was much less used .The effective rate of medical treatment alone was 92 .4% with a mortality rate of 0 .4% .Conclusion The number of hospitalized IBD patients increased in recent years and most of them are young and middle aged .The lesions are mainly moderate . The majority UC cases are chronic and recurrent ;while CD cases belong to inflammatory type and stenotic type predominantly .Par-enteral lesions and complications are rare .Sulphasalazine (SASP)/5-ASA and steroids are still the mainstay agents used for the treatment of IBD .This disease need for long-term maintenance treatment .
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