Analysis Of Clinical Characteristics Of 71 Cases Of Inflammatory Bowel Disease In Western Hunan

Objective:The clinical data of patients with inflammatory bowel disease(IBD)in the western Hunan area during seven years were collected,retrospectively analyzed and discussed the epidemiological characteristics,providing a basis for further summarizing the diagnosis and treatment of inflammatory bowel disease in this area.Methods:Collect clinical data of patients diagnosed with inflammatory bowel disease from January 2012 to January 2019 in Xiangxi People's Hospital,including Ulcerative Colitis(UC)and Crohn's Disease(CD),And analyze the clinical characteristics of the two diseases.Result:1.Population characteristics:The number of inpatients diagnosed with inflammatory bowel disease in our hospital from January 2012 to January 2019 was 71,including 47 cases of ulcerative colitis and 24 cases of Crohn's disease.Ulcerative colitis has a male to female ratio of 1.04:1,Crohn's disease has more males than females(3.8:1),and the age of onset of inflammatory bowel disease ranges from 13 to 78 years.=5.253,P=0.022).The ethnic groups of patients with inflammatory bowel disease in western Hunan include Miao,Han and Tujia,of which Miao and Tujia account for the highest proportion(both 38.0%),followed by Han(23.9%).The average age of ulcerative colitis was 43.3+13.2,and the average age of Crohn's disease was 36.1+16.1.There was no significant difference in the average age of the two groups(t=,1.736,P=0.192,P>0.05).The number of patients with ulcerative colitis has remained unchanged for seven years.Crohn's disease patients have an increasing trend,and the overall number of patients with inflammatory bowel disease has not increased significantly.The crude incidence rate of inflammatory bowel disease fluctuated between 0.196/10million-0.550/10million between 2012 and 2018,and the crude incidence rate of ulcerative colitis fluctuated between 0.078/10million-0.392/10million between 2012 and 2018 The crude incidence rate of Crohn's disease from year to 2018 is 0.078/10million-0.265/10 million,which is gradually increasing.2.Intestinal surgery history:3 cases(6.4%)of intestinal surgery history of ulcerative colitis,7 cases(29.2%)of intestinal surgery history of Crohn's disease,Crohn's disease group:2.3 in ulcerative colitis group:1.The rate of intestinal surgery in Crohn's disease group is higher than that in ulcerative colitis group,the difference is statistically significant(?~2=6.851,p<0.005).3.Clinical manifestations and complications:The clinical manifestations of ulcerative colitis are mainly abdominal pain,mucous pus and bloody stools,and tenesmus.The clinical manifestations of Crohn's disease are mainly abdominal pain,diarrhea and weight loss.After comparing the symptoms of the two groups alone,there was no statistically significant difference in abdominal pain,bloating,tenesmus,and fever(P>0.05).The differences in bloody stools,diarrhea and weight loss were statistically significant(P<0.05).Crohn's disease group had more complications than ulcerative colitis group,and the two groups were statistically significant(?2=14.724,P<0.05).4.Laboratory index:ulcerative colitis group:female patients with ulcerative colitis HGB is(100.5±8.3)g/L,male is(104.4±13.7)g/L,male and female hemoglobin,the difference is not statistically significant(t=1.262,P>0.05).Crohn's disease group:Female Crohn's disease patients with HGB(91.0±0.00)g/L,males(104.4±14.8)g/L,male and female hemoglobin,the difference was statistically significant(t=34.6,P<0.05).The disease activity score of the ulcerative colitis group was positively correlated with the erythrocyte sedimentation rate(r=0.500,P<0.05),hemoglobin(r=-0.159,P<0.05),albumin(r=-0.324,P<0.05)It is negatively correlated.No correlation with C-reactive protein and leukocytes(P>0.05).Crohn's disease activity score was positively correlated with C-reactive protein(r=0.237,P<0.05),erythrocyte sedimentation rate(r=0.348,P<0.05),and albumin(r=-0.187,P<0.05)))There is a negative correlation,no correlation with hemoglobin and white blood cells(P>0.05).The inflammation index CRP in the Crohn's disease group was higher than that in the ulcerative colitis group,and the difference was statistically significant(t=49.548,P<0.05).5.Clinical phenotype,lesion location and severity:ulcerative colitis has 28 cases of initial onset and 19 cases of recurrent type.The range of lesions is classified according to Montreal:the main type is the left colon(E2).Mainly light to moderate.The Crohn's disease group is classified according to Montreal.The number of patients aged 17-40 years(A2)is the largest.The lesions are most common in the colon type(L2)and ileococcal type(L3).)Mainly,severity and light activity period.6.Colonoscopy and pathological manifestations:Colonoscopy showed inflammatory bowel disease mainly including mucosal congestion and edema,erosion,and ulcers.Crohn's disease showed characteristic changes in paving stones nodules under colonoscopy.The pathological manifestations of the ulcerative colitis group are mainly acute or chronic inflammatory cell infiltration,chronic mucosal inflammation,erosion,crypt abscess formation,and gland hyperplasia.The main pathological manifestations of the Crohn's disease group are chronic mucosal inflammation,erosion,and inflammation Cell infiltration,crypt abscess formation,and ulcer formation.7.Treatment:71 cases of inflammatory bowel disease ulcerative colitis group and Crohn's disease group are mainly treated with aminosalicylic acid,followed by hormones.8.Follow-up:47 patients with ulcerative colitis were followed up,10 were lost to follow-up,and 1 died.There were 24 patients with Crohn's disease,6 were lost to follow-up,1 died,and died of infection after perforation.In the ulcerative colitis group,mesalazine,mesalazine+hormone,and Chinese medicine were mainly used outside the hospital,and no patients used immunosuppressants.Patients in the Crohn's disease group mainly use mesalazine outside the hospital,and a small part of them use hormones,azathioprine,surgery,and traditional Chinese medicine.The compliance rate of patients with ulcerative colitis was43.2%;the compliance rate of patients with Crohn's disease was 41.2%.Among the 54 patients with follow-up inflammatory bowel disease,11patients(20.4%)in the remission stable period,33 patients(61.1%)improved effectively,and 10 patients(18.5%)worsened.There was a correlation between compliance and prognosis(?~2=10.688,P=0.01).Conclusion:1.The number of patients with ulcerative colitis in Xiangxi area has not changed in the past seven years,and the number of Crohn's disease has increased.The crude incidence of inflammatory bowel disease in Xiangxi area is at a low level,which is significantly lower than that in coastal developed areas.2.Ulcerative colitis is more common in mild-to-moderate active period,and the left half of the colon is mainly involved;the activity of Crohn's disease is mainly mild,and the affected lesions are mainly ileum type and colon type.3.Mesalazine is the drug with the highest rate of treatment for inflammatory bowel disease in western Hunan.The operation rate of patients with Crohn's disease is significantly higher than that of ulcerative colitis.The treatment compliance of patients with inflammatory bowel disease is poor.The compliance of patients affects the patient's compliance.Outcome of prognosis.