| Objective To analysis the clinical features of hospitalized patients with inflammatorybowel disease (IBD),investigate the factors of efficacy and prognostic throughfollow-up,and appraise the clinical characteristics,influence factors of refractoryrefractory IBD.Methods A retrospective analysis was conducted on the221cases patients withinflammatory bowel disease,who were hospitalized in Anhui Provincial Hospital fromJanuary2000to December2009.To evaluate the clinical features according to the2007Chinese consensus Diagnostic treatment guidelines of IBD.To understand therecurrence time and influencing factors of142cases of recurred patients with IBD bytelephone and letter.According to the reaction to glucosteroids (GCS) treatment,theywere divided into GCS effective group and intracTab group. The general date clinicalsymptoms, endoscopic findings, laboratory findings of the two groups were compared,and further analysis of the clinical characteristics, refractory factors of refractory IBD.Results1Clinical evaluation1.1195patients with ulcerative colitis (ulcertive colotis UC), including112cases ofmale (57.4%),83cases of female(42.6%),The male to female ratio was1.35:1,theaverage age of patients was44.5years,79cases (40.5%) were first onset,95cases (48.7%) were chronic relapsing,The lesions of the rectum56cases (28.7%),Rectum-sigmoid58cases (29.7%)mild63cases (35.4%), moderate86cases (44.1%).The majorsymptoms were diarrhea164cases (82.4%),bloody mucus stool149cases (77.4%),abdominal pain136cases (68.3%);About8cases (4.1%) of UC patients hadex-traintestinal manifestations,and12cases (6.2%) had complications;The mainstay forUC treatment was still5-aminosalicylate (5-ASA) agents (100%) and g1ucocorticoids(22.1%).The remission rate by medicine reached99.5%.1.226patients with Crohn’s disease (Crohn’s disease,CD), including14cases of male(53.8%),12cases of female(46.2%),The male to female ratio was1.17:1,the average ageof patients was28.4years;8cases (30.8%) were narrow type,6cases (23.8%) werepunch-through type.12cases (46.2%) were inflammatory type;The lesions of smallintestinal6cases (23.1%),colon5cases (19.2%),ileocolon15cases (57.7%) wereinvolved.years，mostly with mild to moderate severity,each of nine cases (34.6%),12cases (46.2%);The major symptoms were abdominal pain19cases (73.1%),diarrhea,12cases (46.2%),abdominal mass3cases (11.5%);8cases (30.8%) of CD hadcomplications,8cases were ex-traintestinal manifestations;The mainstay for CDtreatment was still5-ASA agents17cases(65.4%) and g1ucocorticoids19cases(73.1%),3cases patients received immunosuppressive agents,The operation rate is5cases (19.2%).The remission rate by medicine reached80.8%.2Follow-up results197hospitalized patients with IBD filled in the table (UC171cases,CD26cases),follow-up rate89.1%, lost24(10.9%). he time was up to10years from discharged tofollow-up, an average time of3.5years; follow-up in patients with recurrence ofsymptoms in127(64.5%), duration of symptoms in15(7.6%);asymptomatic recurrencein55(27.9%); thesymptoms of recurrence within1year41patients (20.8%),103cases(52.3%)within4years,120(60.9%)within seven years,127(64.5%)within10years.2.1Recurrence of symptoms orduration of symptoms in patients with UC(12170.8%),age>60years (46.2%),mild (43.6%),effective maintenance therapy (22.6%) were significantly lower than other age groups-severe ineffective maintain patients (P<0.05);the incidence of lesions in the left colon (83.9%), colon (81.8%) patients wassignificantly higher than straight, and sigmoid colon (P <0.05); and there was nosignificant difference in gender and laboratory indicators.2.2Recurrence of symptoms or duration of symptoms in patients with CD(2180.7%),age>60years (60.0%), mild (60.0%) patients were significantly lower than other agegroups、severe (P<0.05); there was no significant difference in lesions, maintenancetherapy, laboratory parameters (P>0.05).3Refractory IBD clinical analysisTotally62(31.5%) IBD patients received systemic GCS treatment, refractory groupand effective group take up24cases (38.7%) and38cases(,61.3%); there are nodifference of diagnostic age, sex distribution,severity of illness between the two groups(P>0.05). Compared with effective group,the proportion of intracTab group is higher inmoderately severe bellyache [(9/24,37.5%) vs (5/38,13.2%)](P<0.05);The level ofplatelets,ESR, C-reactive protein in were significantly higher than the effective group[(375±141) vs (217±118),(43.2±38.4) vs (22.4±15.2)(51.2±30.7) vs (21.6±13.4)](P<0.05); The difference of effective group was statistically significant in level ofhemoglobin, serum albumin [(81.3±20.5) vs (65.2±15.7),(31.7±7.6)vs (22.51±10.3)(P <0.05).Conclusion: The hospitalized patients with IBD gradually increased, Medical treatmentare available to clinical remission, but relapse easily.The relapsing factors of IBD areseverity extent of disease,diseased region,standard treatment Anemia, hypoalbuminemia,thrombocytosis, accelerated ESR, Elevated C-reactive protein, severe abdominal pain atthe onset of disease,which may indicate poor response to glucocorticoid treatment. |
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