| Objective To summarize and analyze the clinical features of inflammatory bowel disease(IBD) in Hainan General Hospital. Provide a basis for evidence-based science of diagnosis and treatment of IBD in Hainan.Methods Collecte detail datas of 271 patients with inflammatory bowel disease from Hainan General Hospitan from January 2002 to July 2014 in this study. Analyzed the general information, clinical manifestations, endoscopic and pathological features, laboratory tests, treatment and prognosis of all cases.Results1. General information In all IBD cases, male 171(63.10%), female 100(36.90%), the male to female ratio was 1.71:1. The average age of onset was 48.02±17.25. The peak age of US was between 40 to 59 years old and the CD’s was 30 to 49 years old.2. Clinical manifestation2.1 Intestunal symptoms 90.67% of UC patients with stool frequency and the change of character as the main manifestation(which 70.67% was mucus or pus, 16.44% was diarrhea, 3.11% was constipation, 0.44% was diarrhea alternating with constipation), 70.67% has abdominal pain, 9.78% has abdominal distension, 23.11% has tenesmus, 10.22% has nausea and vomiting. 76.09% of CD patients’ s main performance was abdominal pain, 50% has diarrhea, 17.39% has abdominal distention, 8.7% has abdominal mass.2.2 Systemic symptoms 52.89% of the UC patients has anorexia, fever in 27.56%, anemia in 31.11%, weight loss in 33.33%. 73.91% of the CD patients has anorexia, fever in 47.83%, anemia in65.22%, weight loss in 47.83%.2.3 Extra intestinal manifestations and complications In the UC patients 10.22% had extra intestinal manifestations and 19.57% in CD patients, the most common manifestations were mucocutaneous disease and joint damage. 27.11% of UC patients had complications, and intraepithelial neoplasia or canceration(16.44%) and gastrointestinal bleeding(5.78%) see more. Intestinal obstruction(19.57%) is most common by the CD patients which had complications(39.13%).2.4 Type and severity of clinical A majority of US patients were initial onset type, accounted for 64%, and other 36% were chronic relapsing type. Remove the 3 cases can not be evaluated in phases. The US patients mainly in mild and moderate accounted for 76%, while the remission stage and severe were 4.89% and 17.78%. This is the same in CD patients, the most patiens were initial onset type, accounted for 84.78%, while the remission stage and severe were 8.7% and 6.52%.3.The lesions Exclude the 8 cases that without colonoscopy report, 46.08% of the UC patients were confine to the left colon, 35.02% were involve the whole colon, 11.06% were confine to the rectum, and 5.53% were in the other. 13.95% of the CD patients(remove 3 cases who without colonoscopy report) were confine to the terminal ileum, 34.88% were confine to the colon, 44.44% were involve the ileum and colon, and 4.66% confine to the upper gastrointestinal.4.Endoscopic The mainly endoscopic of the UC and CD patients were hyperemia and edema, erosion, ulcer, and the chronic inflammatory cell infiltration was the main pathological changes.5.Laboratory examination In patients with UC the average WBC was 8.56±4.44×109/L, 24% of the patients increased, the average HB was 120.6±22.08g/L, 31.11% had anemia, the average PLT was 262.97±117.11×109/L, 25.33% of the patients increased, the average Ca2 + was 2.18±0.18mmol/L, 65.78% were reduction.in patients with CD the average WBC was 8.75±4.76×109/L, 28.26% of the patients increased, the average HB was 109.09±25.8g/L, 65.22% had anemia, the average PLT was 306.04±118.92×109/L, 43.49% of the patients increased, the average Ca2 + was 2.11±0.17mmol/L, 76.09% were reduction.6. Treatment and prognosisn The main therapy for patients with IBD in our study was 5-aminosalicylic acid(63.47%), while Immunosuppressant use less. After treatment, 15.87% of patients had complete remission, 61.99% of the patients effectively, and 14.02% of the patients ineffectively, 9.22% of the patients relapse.Conclusions IBD has an asending trend in our hospital year by year in Hainan General Hospital In recent 12 years, and patients with UC much more than patients with CD. The clinical features and treatment with this patients were consistent with the domestic report. Most of them are mild or modemt, extra intestinal manifestations and complications are rare. The vast majority of patients can achieve good curative effect after internal medicine treatment, and have lower recurrence rate. |
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