The Relationship Between Different UC Grade And The Severity And Its Warning Of Diagnosis And Treatment Of Severe UC

Objectiv:To analyze and compare clinical manifestations, endoscopic and pathological features and their correlation of different degrees inpatients with ulcerative colitis (UC); then to analyze the diagnosis,treatment and outcome of severe UC, looking for early warning indicators of severe UC。Methods:We colected 125 inpatients with UC at the the second xiangya hospital of Central South University from December 2004 to December 2010。Eveluation of the prevalence, clinical manifestations, laboratory, endoscopic and pathological features, diagnosis and prognosis between the groups of severity was made。And we compared the correlation among the indexes。Then we analyzed the treatment and outcome of 36 severe UC。Results:(1),The peak age of onset in this group was 40-49 years, mean age 44.82 years o The average duration of the disease was 24 months, mainly to within five years。Chronic recurrence type was the main Clinical types。(2),Diarrhea, pus, mucus stools, fever, anemia, weight loss, pulse rate, complication rate and incidence of fecal occult blood positive for the severity of the disease is correlated。The frequency of its occurrence increased with the increasing trend of exacerbations (P <0.05)。Clinical activity index, ESR, total protein, albumin, c-reactive protein, white blood cells, hemoglobin and platelets in mild,moderate and severe illness there exist obvious differences between the three groups (P<0.01)。(3),There exists significant differences between the endoscopic grade among the mild, moderate and severe three groups (p=0.000)。Severity of disease is closely related to lesions range (p=0.000)。Mild UC was mainly affected the rectal and sigmoid colon。Moderate to severe UC were primarily affected widely colon or whole colon, Brittle mucosal bleeding, formation of false polyps, shallow pocket or disappeared, and the intestinal lumen stenosis coarse grain area change between the groups there were significant differences (P<0.05),more severe disease, the higher the incidence。There were significant differences between groups in histological grade (P<0.01), the more severe the disease, the higher grade。Clinical classification, endoscopic grade, pathological grade correlated with disease severity。(4),Medical treatment was based therapy, some severe patients need surgical treatment。After medical treatment, the disease remission rate was 84.8% (106/125)。(5),The peak age incidence of 36 patients with severe UC was 31-40 years old。Lesions range are mainly affected extensive and the entire colon (75%)。The main drug for symptom control is hormone, its total effective rate was 79.2%。Surgical group with an average age of onset, the average minimum hemoglobin, albumin were lower than the average minimum non-surgical group。Conclusion:1,Severity of disease is closely related to clinical manifestations and lesions range。Diarrhea, pus, mucus stools, fever, anemia, weight loss, rapid pulse, the incidence of complications increased with the severity of an increasing trend。Thrombocytosis, leukocytosis, decreased serum albumin, anemia, elevated ESR and c-reactive protein can reflect the severity of the disease。These indicators can be used as early warning indicators of severe UC。2,UC-based therapy is medical treatment。Mild to moderate patients effect with medical therapy alone。Some severe patients need surgical treatment3,Endoscopic grade, pathological grade, clinical stage and disease severity is related to a certain extent, can reflect the severity of active UC。4,For severe UC, in addition to actively systems of drug treatment, should be timely assessment of drug efficacy and surgical needs. Age of onset of light, wide or full colon lesions, low hemoglobin, hypoalbuminemia are relevant factors of prompted poor drug efficacy and surgical treatment.