| Objective:To analyze the clinical characteristics of patients with chronic recurrence of Ulcerative colitis(UC)and the influencing factors of disease recurrence.Methods: Collected 119 cases of UC patients diagnosed and hospitalized in anhui provincial hospital from January,2015 to June,2018.including frequency of recurrence,gender,age,course of the disease,medical reasons,pathogen infection,maintenance treatment drugs,platelet count,psychological disease status(SAS/SDS score),the range of lesions,disease severity,endoscopic score,drug compliance and disease education.112 cases(excluding 7 cases with continuous UC)were divided into frequent group and occasional group according to the total number of recurrence in one year.Multivariate Logistic regression analysis was used to explore the factors affecting UC frequency.Result:1): From 2015 to 2018,a total of 119 UC patients were collected that met the diagnostic criteria of ulcerative colitis in the consensus opinions on the diagnosis and treatment of inflammatory bowel disease of the Chinese medical association in 2018.Among them,51 cases(42.8%)were sporadic type,61 cases(51.3%)were frequent type,and 7 cases(5.9%)were persistent type,the ratio of male to female was 13:10,the average age was 40.5±12.1 years,the average course of disease was 5.7±5.2years.18(15.1%)patients with abdominal pain and diarrhea,76(63.9%)patients with bloody stools,and 25(21.0%)patients with abdominal pain and bloody stools went to the doctor.There were 4 cases of SASP,85 cases of 5-aminosalicylic acid(5-ASA),28 cases of immunosuppressant(23.5%),and 2 case of infliximab intravenous infusion.2): Accidentally hairstyle UC,a total of 51 cases,male 31 cases,women in 20 cases,average age 40.3±11.8 years and average duration 5.9±5.1 years,the platelet count is greater than 300 x 10 ^ 9 /L 11 cases(11/51,21.6%).There were 2 cases of SASP,36 cases of 5-ASA(70.6%),11 cases of immunosuppressant(21.6%),and 2 case of intravenous infliximab.SAS score 38.1±8.5,SDS score 40.3±9.7.There were 6 cases(11.8%)with lesion located in rectum,21 cases(41.2%)with left half coln and 24 cases(47.0%)with extensive colon.45 cases(88.2%)were mild to moderate,and 6 cases(11.8%)were severe.The endoscopic score was greater than 1 in 23 cases(45.1%).Drug compliance was good in 30 cases(58.8%)and poor in 6 cases(11.8%).The average frequency of receiving disease education was 7.2±2.6 times.There were 28 cases(54.9%)with good disease education and 5 cases(9.8%)with poor disease education.3): There were 61 cases of frequent UC,including 36 males and 25 females.average age 40.6±12.1years and average duration 5.6±5.2 years,the platelet count is greater than 300 x 10 ^ 9 /L 16 cases(16/61,26.2%).There were 1 cases of SASP,44 cases of5-ASA(72.2%),16 cases of immunosuppressant(26.2%).SAS score 46.7±11.2,SDS score 48.5±10.2.There were 7 cases(11.5%)with lesion located in rectum,23 cases(37.7%)with left half coln and 31 cases(50.8%)with extensive colon.31 cases(50.8%)were mild to moderate,and 30 cases(49.2%)were severe.The endoscopic score was greater than 1 in 55 cases(90.2%).Drug compliance was good in 18 cases(29.5%)and poor in 15 cases(24.6%).The average frequency of receiving disease education was 5.5±2.4 times.There were 14 cases(23.0%)with good disease education and 14 cases with poor disease education.4): Among the 7 cases of continuous UC,the ratio of male to female was 0:7,the average age was 42.6 years,and the average course of disease was 4.7 years.Among them,4 cases were complicated with cytomegalovirus infection,and 1 case was complicated with tuberculosis infection.There were 1 case of SASP,5 cases of 5-ASA,and 1 case of immunosuppressive agent.The lesion range was extensive colon,the lesion degree was severe,and the endoscopic score was greater than 1.Drug compliance was good in 3 patients,moderate in 2 patients,poor in 2 patients,and moderate in 7 patients receiving disease education.5): Univariate analysis showed that SAS/SDS score,disease severity,endoscopic score,drug compliance and disease education were significantly correlated with UC frequency(P<0.05),while gender,age,course of disease,platelet count and lesion range were not correlated with UC frequency.Multivariate Logistic regression analysis showed high SAS/SDS score(OR(95%CI):1.10(1.05-1.16)/1.08(1.00-1.17),P<0.05),severe illness(OR: 4.67,95%CI(1.02-21.28),P<0.05),endoscopic score greater than 1(OR:13.82,95%CI(3.82-49.99),P< 0.01),poor drug compliance(OR:1.41,95%CI(1.19-1.84),P<0.05)and poor disease education(OR:1.35,95%CI(1.06-1.80),P<0.05)are risk factors for the frequent occurrence of chronic recurrent UC.Conclusion:There were 119 patients with UC recurrence,with the highest frequency of 51.3%(61 cases).There were more males than females,and there were more patients aged 30-50 years old with a course of disease longer than 5 years.Anxiety and depression,severe disease,endoscopic mucosal score greater than 1,poor drug compliance and poor disease education can lead to recurrent UC in UC patients,and the difference is statistically significant.However,gender,age,course of disease,platelet count,major maintenance therapy drugs,and lesion range were not correlated with UC frequency. |
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