| Objective: To investigate the epidemiological characteristics of hospitalized patients with inflammatory bowel disease(IBD)in southwest Fujian Province.Methods: Patients with inflammatory bowel disease admitted to Zhongshan Hospital Xiamen University from January 2015 to December 2019 were selected as the research objects,and their medical records were collected and analyzed retrospectively.The patients were divided into CD group and UC group,and the gender,age of diagnosis,urban and rural division,lesion location,disease behavior,extraintestinal manifestations,complications,intestinal surgery,and drug use were counted respectively.Results: 317 patients were included in the study,including 212 patients with CD(male to female ratio: 2.07:1),105 patients with UC(male to female ratio: 1.84:1).1.Population characteristics: the age at diagnosis of CD patients was 29(24.00,36.75)years old,mainly A2(74.6%),and the age at diagnosis of UC patients was 44.10 ±14.357 years old,there are obvious differences(p< 0.001).CD patients living in cities and towns(above town)accounted for 58.02%,living in rural areas accounted for41.98%;UC patients living in cities and towns(above town)accounted for 58.10%,living in rural areas accounted for 41.9%;During the follow-up of this study,the operation rate of CD patients was higher than that of UC patients,and there are obvious differences(17.92% vs 4.76%,p = 0.000).2.Extraintestinal manifestations and complications: there were 4 cases of extraintestinal manifestations in CD patients,including 1 case of arthritis and 3 cases of oral ulcer.The incidence of fistula(including intestinal fistula,extraintestinal fistula,etc.)was 16.51%,and the incidence of intestinal obstruction was 9.91%,The incidence of perianal lesions was 15.09%,abdominal abscess was 6.13%,intestinal perforation was 2.83%,and gastrointestinal bleeding was 0.47%.Three patients with UC had extraintestinal manifestations,including 1 case of arthritis,2 cases of oral ulcer,1 case of canceration,1 case of intestinal perforation,and 1 case of intestinal obstruction.3.Clinical phenotype distribution:The age of diagnosis of CD patients was mainly A2 type(74.06%),the lesion location was mainly L3 type(53.3%),and the disease behavior was mainly B2 type(62.7%).According to the statistical analysis,there was significant difference in the age of diagnosis of CD between different genders.Type A2 was the main type in males and type A3 was the main type in females.The distribution of disease behaviors of men and women was the same,and B2 type was the main type.There were differences in disease behaviors.The proportion of B2 type in women was significantly higher than that in men(73.9% vs 57.3%,P = 0.019).Type L2 had the highest proportion of perianal lesions.The lesions of UC patients were mainly E3,while chronic recurrence was the main clinical type(62.9%).There was no significant difference in age of diagnosis,location and clinical type of UC between different genders(p > 0.05).The range of lesions was not completely consistent with the degree of disease activity(p< 0.05).4.Therapeutic drugs: 28.3% of CD patients were treated with 5-aminosalicylic acid(5-ASA),25.9% with glucocorticoids,59.4% with immunosuppressants,37.3% with infliximab,18.4% with infliximab,61.8% with nutrition,and 0.5% with enterobacteria transplantation;94.3% with UC,38.1% with 5-ASA Among them,16.2% received glucocorticoids,16.2% received immunosuppressive agents,6.7%used infliximab,23.8% used nutritional therapy,and 20.0% participated in fecal bacteria transplantation(FMT).Conclusion: In recent 5 years,CD was more in patients with IBD than that in patients with UC,male dominated.The clinical manifestations of IBD patients in our hospital are various,including arthritis and oral ulcer.The incidence of fistula formation in CD patients is high,and the incidence of UC patients is significantly low.The age at diagnosis of CD patients was mainly A2 type,the lesion site classification was mainly L3 type,and the disease behavior was mainly B2 type;the lesion site of UC patients was mainly E3 type,and the clinical type was mainly chronic recurrence.Most patients with CD received immunosuppressive therapy,followed by biological agents,5-aminosalicylic acid preparations,glucocorticoids,etc.patients with mild to moderate UC were mainly treated with 5-ASA preparations and glucocorticoids,while patients with glucocorticoids,immunosuppressive agents,and biological agents were mostly moderate to severe.The proportion of UC patients receiving FMT is higher than CD.Objective: Objective to study the degree of ulcerative colitis burden of luminal inflammation(DUBLIN)score in in evaluating the severity of ulcerative colitis(UC).Methods: A total of 105 UC patients with complete endoscopic data were included,and the endoscopic score was evaluated according to the Mayo endoscopic score(MES),and the inflammatory burden was evaluated according to the DUBLIN score.The clinical indicators including Mayo score,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and albumin(ALB)were collected during regular follow-up,,the patients in the activity group were divided into groups,and the differences of CRP,ESR,ALB,MES score and DUBLIN score of different groups were compared,,The correlation between DUBLIN score and CRP,ESR,ALB and Mayo score in this group of patients was tested,and the evaluation efficacy of DUBLIN score and MES score on severe UC was compared.Results:There were statistical differences in CRP,ESR,ALB,MES score and DUBLIN score among patients with different activity levels of UC.DUBLIN score was positively correlated with ESR,CRP,and Mayo score(r=0.317,r=0.419,r=0.625,p≤0.001),and negatively correlated with ALB(r=-0.422,p< 0.001).The area under the ROC curve(AUC)of severe UC judged by DUBLIN score was 0.785.Higher than MES score(AUC=0.631).Ordered regression showed that DUBLIN score was a risk factor for disease severity(P < 0.05,β = 0.351,95% CI: 0.130-0.573).Conclusion: DUBLIN score was correlated with CRP,ESR,ALB and Mayo score.DUBLIN score was a risk factor of disease severity.DUBLIN score was better than MES score in judging severe UC,which had higher clinical application value. |
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