| Objective:1.Analysis and comparison of elderly-onset ulcerative colitis(EOUC)and none elderly-onset ulcerative colitis(EOUC)in Jiangsu University Affiliated Hospital(N-EOUC)inpatients with clinical manifestations,laboratory examination,diagnosis and treatment,hospitalization costs and other aspects of differences and characteristics,in order to provide reference and basis for EOUC diagnosis and treatment.2.To understand the detection of Norovirus(NOV),Rotavirus(ROV),Adenovirus(Ad V),Astrovirus(Ast V)and Sapovirus(Sa V)in faecal samples of EOUC and N-EOUC inpatients.To analyze the correlation between gastroenteritis virus infection and the severity of UC patients and the range of lesions involved.Methods:1.Collected during November 2011 to November 2020 Jiangsu University Affiliated Hospital diagnosed with UC of hospitalized patients with complete clinical data,it can be divided into EOUC group and N-EOUC group,the two groups of clinical symptoms,laboratory results and endoscopic examination results,disease severity,pathology,treatment,hospitalization days and medical expenses are compared and analyzed.2.Stool samples were collected from UC patients hospitalized in the Department of Gastroenterology,Affiliated Hospital of Jiangsu University from October 2019 to October2021.Multiplex RT-q PCR was used to detect the above five gastroenteritis viruses in the stool samples,and the results were analyzed and compared.Results:1.Clinical characteristics of EOUC: A total of 253 UC inpatients meeting the inclusion criteria were collected from November 2011 to November 2020,including 140 males and 113 females,with a male to female ratio of 1.24:1.There were 79 patients in EOUC group,accounting for 31.23%(79/253)of the hospitalized patients in the same period.The age ranged from 60 to 83 years,with an average age of 68.91±6.84 years,and the male to female ratio was1.03:1.174 patients in N-EOUC group accounted for 68.77%(174/253)of the hospitalized patients in the same period,aged from 16 to 59 years old,average age 41.28±11.07 years old,male to female ratio was 1.35:1.(1)Mucopurulent bloody stool,abdominal pain and diarrhea were the main gastrointestinal manifestations in both EOUC group and N-EOUC group,but extraintestinal manifestations were rare,with no statistical significance(P > 0.05);(2)Compared with N-EOUC group,EOUC group was more prone to weight loss and anemia,with more complications(such as hypertension,cholecystitis,type 2 diabetes,etc.),and the difference was statistically significant(P < 0.05);(3)Compared with N-EOUC group,erythrocyte,hemoglobin and albumin in EOUC group were lower,while CRP,ESR,plasma fibrinogen and D-dimer were higher,the differences were statistically significant(P < 0.05).(4)Compared with N-EOUC group,the total opportunistic infection rate(including fungi,cytomegalovirus,Epstein-Barr virus,Clostridium difficile and Shigelomonas)and the total positive rate of autoantibodies were higher in EOUC group,but the difference was not statistically significant(P > 0.05).Compared with N-EOUC group,Centromere Protein B(CENP-B)antibody was more common in EOUC group,and the difference was statistically significant(P < 0.05).(5)Compared with the N-EOUC group,the scope of endoscopic lesions involved in the EOUC group was more likely to be E3 type,more likely to be histopathologically abnormal hyperplasia,and higher modified Mayo score,with statistical significance(P < 0.05).(6)Compared with N-EOUC group,EOUC group had a higher surgical rate,and the difference was statistically significant(P < 0.05).(7)Compared with N-EOUC group,there was no statistical difference in the utilization rates of mesalazine,salazosulfapyridine,hormones,biologicals and immunosuppressants in EOUC group(P > 0.05);(8)Compared with N-EOUC group,EOUC group had higher length of hospitalization and total hospitalization cost,with statistical significance(P < 0.05).2.Detection of 5 gastroenteritis viruses and its effect on UC outcome: A total of 77 stool samples meeting the inclusion criteria were collected between October 2019 and October 2021.Among them,31 patients in EOUC group were aged from 60 to 85 years,with an average age of68.06±5.86 years,and the male to female ratio was 1.21:1.46 subjects in N-EOUC group were aged from 16 to 59 years,with an average age of 39.63±11.10 years and a male to female ratio of1.71:1.The total detection rate of gastroenteritis virus in UC patients was 41.56%(32/77).There were 2 cases of multiple gastroenteritis virus infection,which were NOV GⅡ combined with Ad V infection and NOV GⅠ combined with Sa V infection.The total detection rate of NOV was19.48%(15/77),including 7.79%(6/77)for NOV GⅠ and 11.69%(9/77)for NOV GⅡ.ROV detection rate was 11.69%(9/77),Ad V detection rate was 6.49%(5/77),Ast V detection rate was5.19%(4/77),and Sa V detection rate was 1.30%(1/77).The total detection rate of gastroenteritis virus in EOUC group was higher than that in N-EOUC group,but the difference was not statistically significant(48.39% vs.36.96%,P > 0.05).The total detection rate of NOV in EOUC group was significantly higher than that in N-EOUC group(32.26% vs.10.87%,P <0.05).There was no correlation between the total detection rate of gastroenteritis virus and the severity of UC(r=0.147,P > 0.05),nor between it and the scope of lesion involvement under endoscopy(r =0.112,P > 0.05).Conclusion:1.The number of UC and EOUC inpatients showed an increasing trend.Compared with N-EOUC,EOUC group was more serious,E3 type was more common,more complications,more prone to systemic symptoms,easier to undergo surgical treatment,more need to prevent thrombosis events and the possibility of cancer.Patients in the EOUC group needed to invest more in diagnosis and treatment costs.2.Gastroenteritis virus was detected in nearly half of UC inpatients,with NOV being the most common.Patients with EOUC are more likely to be co-infected with NOV than patients with N-EOUC.Gastroenteritis virus infection did not affect the severity of UC and the range of lesions involved. |
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