| Objective:To explore the clinical features,clinical classification and correlation of patients with inflammatory bowel disease(IBD)were first diagnosed,and to provide a basis for the diagnosis,treatment,prevention and health education management.Methods:The clinical data of patients with IBD first diagnosed admitted to the Shengjing Hospital of China Medical University from January 2017 to October 2019were collected.The clinical features of the disease,such as the general characteristics,clinical manifestions,severity classification,therapeutic drugs and the distribution of clinical subtypes were analyzed and snummarized.Results:1.A total of 242 patients with IBD first diagnosed were admitted in the past 3 years,including 140 patients with ulcerative colitis(UC)and 102 patients with Crohn's disease(CD).2.General characteristics of population:The ratio of male to female in UC was 1.3:1,and that in CD was 1.9:1;The age of diagnosis of IBD ranged from 13 to 85 years old,the average age of diagnosis of UC was 45.48±17.31 years old for males and 44.92±15.28years old for females;that in CD was 30.02±13.39 years old and 33.71±14.22 years old,there was no significant difference in the age of diagnosis between different genders for both UC and CD(p>0.05).The smokers for UC and CD accounted for 10%and 15.69%,respectively.The distribution of UC and CD was higher in urban areas than in rural areas,with a ratio of 1.7:1 and 2.1:1,respectively,and the difference was statistically significant(p<0.05).Among the patients with UC and CD,2 cases(1.43%)and 9 cases(8.82%)had a history of appendicitis surgery,respectively.Among the UC patients,2cases(1.43%)had a clear family history,while that was no found in the CD patients.3.Clinical manifestations:The main manifestions of UC patients in digestive system were abdominal pain(66.42%),diarrhea(95.00%),mucopurulent bloody stool(84.29%);the systemic symtoms were anemia(62.14%),fever(17.86%)and weight lose(45.00%);about 5.71%of patients showed extraxintestinal manifestations,including 7 cases of oral ulcers,1 case of hepatobiliary disease;2.86%of patients had related complications,1case of colorectal canceration,3 cases of colic hemorrhage.The main manifestions of CD patients in digestive system were abdominal pain(81.37%),diarrhea(54.90%);the systemic symtoms were anemia(63.73%)and weight lose(53.92%);about 27.45%of patients showed extraxintestinal manifestations,including 26 cases of oral ulcers,2 cases of erythema nodule;46.08%of patients had related complications,and the incidence of perianal lesions was the highest(24.51%).4.Therapeutic drugs:In patients of UC,94.29%used 5-ASA preparations,20.00%used glucocorticoids and 22.86%used biological agents.In CDs,16.67%received 5-ASA preparations,10.78%received glucocorticoids,23.53%received immunosuppressants and 86.27%received biological agents.5.Clinical classification:In this group with UC,41.43%UC patients belonged to the initial onset type,58.57%belonged to the chronic recurrence type,mild 14.29%,moderate 45.00%and severe 40.71%,type E1 5.72%,type E2 37.14%,type E3 57.14%.According to the analysis,there was no statistic difference in the clinical type,extraxintestinal manifestations and complications of UC at different lesions location(p>0.05),while there were statistic differences in the severity(p<0.05),and type E1 is significantly different from type E2 and E3,respectively.There was no statistic difference in the severity,extraxintestinal manifestations and complications of UC among different clinical types(P>0.05).There was no statistic difference in the lesion location,clinical type and severity of UC at different age of diagnosis(P>0.05).There was no statistic difference in the lesion location,clinical type and severity of UC between different genders(P>0.05).There was no statistic difference in the lesion location,clinical type and severity of UC in different smoking conditions(P>0.05).In patients with CD,type A1 10.78%,type A2 65.69%,type A3 23.53%;type L1 18.63%,type L222.55%,type L3 51.96%,type L4 6.86%,type L1+L4~b 0%,type L2+L4~b 1.96%,type L3+L4~b 3.92%;type B1 56.86%,type B2 32.35%,type B3 10.79%,type B1p~c 16.67%,type B2p~c 6.86%,type B3p~c 0.98%.According to the simplified CDAI score,mild 9.80%,moderate 79.41%and severe 10.79%.There was no statistic difference in the disease behavior and extraxintestinal manifestations of CD at different lesions location(p>0.05),while the difference of perianal lesions in different lesions location was statistically significant(p<0.05),and type L4 is significantly different from type L1,type L2 and type L3(p<0.05),respectively.There was no statistic difference in the disease behavior and perianal lesions of CD in the case of lesions involving the upper gastrointestinal tract(p>0.05),while the difference of extraxintestinal manifestations was statistically significant(p<0.05).There was no statistic difference in the age of diagnosis,lesions location,disease behavior and perianal lesions between different genders(P>0.05),but the difference of extraxintestinal manifestations was statistically significant(p<0.05).There was no statistic difference in the age of diagnosis,disease behavior and severity of CD in different smoking conditions(P>0.05),while the difference of lesions location was statistically significant(p<0.05),presenting in type L3 and type L2.Conclusion:UC accounts for the majority of IBD patients first diagnosed in our hospital in the past 3 years.UC and CD vary in clinical manifestations,the patients with CD showed extraxintestinal manifestations and complications higher than in UC.In terms of the choice of therapeutic drugs,UC was mainly 5-ASA preparations,while CD was mostly biological agents.There is a certain correlation between different clinical classification and clinical subtypes,which can be uesd to provide the basis for clinical diagnosis,treatment and prediction prognosis,but some of the results is inconsistent with the domestic and foreign studies,which may be related to a variety of factors(sample size,race,regional differences,etc),and need to be further confirmed by studies. |
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