| Background: Ulcerative colitis(UC)is an immune-related chronic intestinal inflammatory disorder,the lesions of which are not only limited to the intestinal tract,but also accompanied by a variety of extraintestinal manifestations.The analysis of the clinical characteristics and risk factors of extraintestinal manifestations is helpful to early diagnosis and treat in time,and finally improve the prognosis of ulcerative colitis.Objective: A retrospective analysis of the clinical characteristics and risk factors of extraintestinal manifestations in patients with ulcerative colitis were performed in order to provide reference for clinical diagnosis and treatment of ulcerative colitis.Methods: Patients with ulcerative colitis were included in the second affiliated Hospital of Dalian Medical University from May 2017 to September 2020.According to the presence of extraintestinal manifestations,all patients were divided into EIM group and non-EIM group.The differences in age,gender,body mass index(BMI),smoking history,course of disease,severity of disease,the range of lesion,clinical typing,serum interleukin-6(IL-6),serum interleukin-1-beta(IL-1β),serum tumor necrosis factor-alpha(TNF-α),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),albumin(Alb),hemoglobin(Hb)and anti-neutrophil cytoplasmic antibody(ANCA)were compared and analyzed between the two groups.Furthermore,the risk factors affecting the occurrence of extraintestinal manifestations were explored.Results:1.General data: a total of 122 patients with ulcerative colitis were included,including 61 males(50%)and 61 females(50%),with an average age of 44.1±13.8 years,of which 23.8%(29 cases)were with extraintestinal manifestations.2.Organs involved in extraintestinal manifestations: the common extraintestinal manifestations were joint manifestations(19 cases,15.6%),oral manifestations(13 cases,10.7%),skin manifestations(4 cases,3.3%),eye manifestations(1 case,0.8%)and pulmonary manifestations(1case,0.8%).Besides,there were 7 cases(5.7%)were accompanied by two or more kinds of extraintestinal manifestations.3.Factors related to the occurrence of extraintestinal manifestations: The levels of serum IL-6(p=0.019),TNF-α(p=0.000),C-reactive protein(p=0.037)and severity of disease(p=0.015)were related to the occurrence of extraintestinal manifestations in patients with ulcerative colitis,and the difference between the two groups was statistical significant(p < 0.05).4.Risk factors of extraintestinal manifestations:i)Univariate analysis showed that erythrocyte sedimentation rate(p=0.043),C-reactive protein(p=0.042),serum TNF-α(p=0.000)levels and severe disease activity(p=0.038)were risk factors for extraintestinal manifestations in patients with ulcerative colitis.ii)Multivariate analysis showed that serum TNF-α level(p=0.001)was an independent risk factor for extraintestinal manifestations in patients with ulcerative colitis.The pateints were further divided into normal group and increased group according to the serum TNF-α level,and the comparison between the two groups showed that the risk of extraintestinal manifestations in the group with high serum TNF-α level was 3.5 times higher than that in the group with normal serum TNF-α level(OR =3.5,95%CI:1.363-8.986).Conclusion: Ulcerative colitis can be accompanied by a variety of extraintestinal manifestations,the most common of which are joint manifestations and cutaneous mucosal manifestations.The levels of serum IL-6,C-reactive protein and serum TNF-α are increased in patients with ulcerative colitis accompanied by extraintestinal manifestations,which are related to disease severity.Erythrocyte sedimentation rate,C-reactive protein,serum TNF-α level and severe disease activity are risk factors for extraintestinal manifestations in patients with ulcerative colitis,and the increase of serum TNF-α level is an independent risk factor for extraintestinal manifestations in patients with ulcerative colitis. |
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