| Objective: Ulcerative colitis (UC) has been considered to be uncommon in China in the past. However, several reports have shown that there is a trend toward an increased level of Chinese UC cases in the People's Republic of China in recent years. Furthermore, few reports have been published regarding their clinical aspects, and there have been no epidemiological data on the incidence and prevalence of UC in China. We aimed to identify clinical course and prognosis in a prospective, patients-based follow-up study, and investigated the clinical characteristics and chronological change of UC patients in PLA hospital.Methods: Patients diagnosed with ulcerative colitis during the period from 1992 to 2007 in PLA hospital were registered and their clinical profiles were analyzed. The chronological changes in clinical aspects, such as onset age, sex distribution, severity, extent of disease, clinical course, and corticosteroid use, were also determined. The evaluation at patients-based follow-up included an interview, clinical examination, laboratory tests, and colonoscopy. The time of the case enrolled in this study is surgical time. All follow-up ended on October 1, 2007. Relapse rate were estimated by the methods of Kaplan-Meier and log-rank test were used to determine unvaried significance. Factors that were deemed of potential importance on unvaried analysis were included in the multivariate analysis by the Cox multivariate regression model. Relations between two factors were assessed using the Mann-Whiney test. Probability values < 0.05 were considered statistically significant. Statistical analyses were carried out with SPSS for Windows, versionl2.0.Results: From 1992 to 2007, of 525 patients diagnosesed with UC, with a median onset age of 42 years. The predominant form of UC was extensive colitis, which affected almost 33.3%, Left-sided colitis was present in 21.3% and proctitis was present in 12.4%. the chronic relapse type of UC was the most common (68%), followed by the initial onset type (19%), chronic continuous type with intermittent exacerbations (10%), and acute fulminate type (3%). 221 patients (42.1%) were graded as mild, 162 (30.9%) as moderate, and 142 (27%) as severe UC.The proportion of mild colitis and proctitis was significantly larger in patients with an onset at over 60 years of age, relative to those with an onset at less than 30 years(p<0.05). The proportion of ulcerative colitis patients with old age onset (p<0.05), male sex (p<0.01), mild colitis (p<0.01), proctitis (p<0.01), relapse-free type (p<0.01) demonstrated a chronological increase from 1992 to 2007.A relapse-free course was observed in 24% of the patients. A decrease in symptoms during the follow-up period was the most frequent course taken by the disease and was observed in 56% of the cases. The extent of disease was unrelated to symptoms and also to relapse rate and course of disease during the follow-up period.Of 273 Patients with CRP were enrolled in this study. In UC patients, CRP elevation was significantly associated with severe clinical activity, elevation in sedimentation rate, anemia, hypoalbuminemia, and active disease at ileocolonoscopy.Continuous therapy is independent predictor for relapse of UC. And sex, age, motion are relative factors for relapse of UC. The relapse proportion of female is larger than that of male. And affecting motion often cause to relapse. Relative to those with an onset at less than 30 years. The proportion of ulcerative colitis patients replase-free is larger.Conclusions:1,The disease course and prognosis of UC appears better than previouslydescribed in the literature. A minority of the patients had symptoms thatinterfered with their everyday activities 5 years after diagnosis. The rate ofrelapse-free is 24%. Neither the extent of disease nor the locations of disease are related to the number of relapse.2,CRP elevation in UC patients is associated with clinical disease activity, endoscopic inflammation, severely active histologicinflammation (in CD patients), and several other biomarkers of inflammation.3,Continuous therapy is independent predictor for relapse of UC. And sex, age, motion are relative factors for relapse of UC. Relative to those with an onset at less than 30years. The proportion of ulcerative colitis patients replase-free is larger.4,Relative to those with an onset at less than 30 years, The proportion of mild colitis and proctitis was significantly larger in patients with an onset at over 60 years of age,. And the proportion of ulcerative colitis patients with old age onset, male sex, mild colitis, proctitis, relapse type were less.5,The distinctive clinical features and chronological change were seen in UC patients in recent years. The data of this study can help understand clinical aspects of ulcerative colitis patients in China, where the incidence of ulcerative colitis is still increasing.
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