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目的探讨老年和中青年溃疡性结肠炎(UC)患者临床特点的异同性。方法对2004年9月至2013年1月在北京协和医院诊治的276例UC患者进行回顾性分析。分为老年组(≥60岁)25例及中青年组(<60岁)251例,比较两组在性别组成、病变范围、病情严重程度、临床类型、肠外表现、并发症、内镜及病理表现、治疗方法、激素疗效等方面的异同。结果老年组男17例,女8例;平均病程(71.24±92.01)个月。中青年组男130例,女121例;平均病程(71.84±82.60)个月,老年组中男性比例较中青年组大,两组比较差异有统计学意义(P<0.05);老年组中无一例有家族史,中青年组有家族史者4例(1.6%);老年组以直肠和左半结肠受累多见(68.0%),中青年组以广泛结肠受累多见(72.5%),两组比较差异有统计学意义(P<0.05);老年组轻型所占比例(36.0%)较中青年组(18.7%)高,两组比较差异有统计学意义(P<0.05);老年组激素及免疫抑制剂使用比例(52.0%、4.0%)较中青年组(71.3%、30.7%)低,两组比较差异有统计学意义(P<0.05);激素治疗中,老年组发生骨质疏松者3例(23.1%),中青年组5例(2.8%),两组比较差异有统计学意义(P<0.05);两组病程、临床类型、肠外表现、并发症、内镜及病理表现、氨基水杨酸类药物使用率、手术率、激素疗效差异无统计学意义(P>0.05)。结论同中青年UC患者相比,老年UC患者中男性比例明显升高,遗传因素影响小,病变范围以直肠和左半结肠为主,病情相对较轻。老年UC患者内科治疗药物以氨基水杨酸类为主,激素及免疫抑制剂、生物制剂使用相对较少。激素疗效同中青年UC患者相似,但激素相关副反应,如骨质疏松发生率较高。
Objective To investigate the clinical characteristics of the elderly and middle-aged patients with ulcerative colitis (UC). Methods 276 UC patients diagnosed and treated in Peking Union Medical College Hospital from September 2004 to January 2013 were retrospectively analyzed. There were 25 cases in the elderly group (≥60 years old) and 251 cases in the middle-aged and young group (<60 years old). The differences in gender, disease range, severity of the disease, clinical type, extraintestinal symptoms, complications, Pathological findings, treatment, hormone effects and other aspects of the similarities and differences. Results The elderly group of 17 males and 8 females; average duration (71.24 ± 92.01) months. There were 130 males and 121 females in the middle-aged and young groups, with an average duration of (71.84 ± 82.60) months. The proportion of males in the elderly group was larger than that in the middle-aged and young groups, with significant difference between the two groups (P <0.05) One case had a family history, and 4 cases (1.6%) had a family history of middle-aged and young people. The older group had more involvement of the rectum and left colon (68.0%), and the middle-aged and young group had extensive colon involvement (72.5%), (P <0.05). The proportion of mild type in elderly group (36.0%) was higher than that in middle-aged group (18.7%), the difference was statistically significant (P <0.05) (52.0%, 4.0%) were lower than those in middle-aged group (71.3%, 30.7%), the difference between the two groups was statistically significant (P <0.05). In the hormone therapy group, the incidence of osteoporosis (23.1%), and 5 cases (2.8%) in middle-aged and young patients. There were significant differences between the two groups (P <0.05). The duration of disease, clinical type, extraintestinal function, complications, endoscopy and pathology Performance, the use of aminosalicylic drugs, surgical rate, hormone effect difference was not statistically significant (P> 0.05). Conclusion Compared with middle-aged and young patients with UC, the proportion of male patients with UC was significantly higher than that of middle-aged and young patients. The influence of genetic factors was insignificant. The extent of the lesion was mainly in the rectum and left colon, and the disease was relatively mild. Medical treatment of elderly patients with aminosalicylic acid-based drugs, hormones and immunosuppressive agents, biological agents used relatively small. Hormone effect similar to young patients with UC, but hormone-related side effects, such as a higher incidence of osteoporosis.