| Objective:Through retrospective analysis of young/middle-aged and elderly patients with ischemic colitis(IC),compare the clinical characteristics of IC patients at different ages,and analyze the risk factors of the onset of IC in different ages.Methods:1.Taking 189 patients diagnosed as IC in our hospital as the research object,they were divided into young/middle-aged group(68 cases)and elderly group(121 cases,including 60-year-old)according to the age at 60 years old.Collect complete clinical data and compare the clinical characteristics of the two groups of patients.2.The selected 189 cases(68 cases in the young/middle-aged group and 121 cases in the elderly group)IC patients were used as the case group,and another 189 cases(68 cases<60 years old,121 cases≥60 years old)selected by stratified sampling method at the same period In our department,patients who had normal colonoscopy and had no previous intestinal organic diseases were used as a control group,and collected relevant data such as previous medical history,surgical history and drug use for statistical analysis,and compare the difference between the case group and the control group of each age group to explore the risk factors of IC in the young/middle-aged group and the elderly group.Results:1.The young/middle-aged group and elderly group patients were mostly females,and the clinical manifestations were mainly abdominal pain and hematochezia,followed by nausea,vomiting and diarrhea.There was no significant difference(P>0.05).The proportion of young/middle-aged group patients with abdominal surgery history was higher than that of the elderly group,but the difference was not statistically significant(P>0.05).The ratio of elderly patients with hypertension,diabetes,coronary heart disease,and β-blockers was higher than that of young/middle-aged groups,and the difference was statistically significant(P<0.05).The levels of D-dimer in the elderly group were higher than those in the young/middle-aged group,and the levels of hemoglobin and albumin were lower than those in the young/middle-aged group,the difference was statistically significant(P<0.05).The elderly group was more likely to have celiac artery,iliac artery,and superior mesenteric artery lesions,and the difference was statistically significant(P<0.05).In the two groups of IC patients,the results of abdominal CT examination were mainly manifested as thickened intestinal wall edema and obscure fat gap,the difference was not statistically significant(P>0.05).In terms of lesions,both groups of IC patients are more likely to occur in the left hemicolon.Microscopic manifestations mainly include congestion,edema,erosion,and ulcer formation.Some patients have bleeding,white fur,narrowing of the bowel cavity,and blood vessels with unclear or disappearing texture.The proportion of patients with unclear or disappearing blood vessel texture in the elderly group was significantly higher than that in the young/middle-aged groups,and the difference was statistically significant(P<0.05).The two groups of IC patients were mainly treated by medical treatment,and the effect was good.Only one elderly patient died during hospitalization,and the rest were got better.2.Univariate analysis shows:The IC patients in the young/middle-aged group were significantly higher than those in the young/middle-aged control group in terms of female and abdominal surgery,and the difference was statistically significant(P<0.05).The IC patients in the elderly group were significantly higher than those in the elderly control group in terms of female proportion,hypertension,diabetes,coronary heart disease,hyperlipidemia,CCB taking history,and history of abdominal surgery(P<0.05).Multivariate analysis shows:Female and history of abdominal surgery are risk factors for IC in the youth/middle-aged group;female,hypertension,diabetes,coronary heart disease and history of abdominal surgery are risk factors for IC in the elderly group.Conclusion:1.The proportion of female IC patients in the young/middle-aged group and the elderly group is higher than that of male,and the clinical manifestations are mainly abdominal pain and hematochezia.2.The elderly patients had higher rates of hypertension,diabetes,coronary heart disease,abdominal vascular disease and taking β-blockers is higher than that of young/middle-aged group,suggesting that the proportion of vascular lesions and insufficient perfusion in elderly IC patients is higher.3.Colonoscopy is helpful for early diagnosis of IC.Two groups of IC patients are prevalent in the left hemicolon.There is no obvious difference under colonoscopy,the microscopic manifestations of the two groups were mainly transient manifestations such as congestion,edema,erosion,and ulcers.The effect of conservative medical treatment was effective in both groups of IC patients.4.Female and history of abdominal surgery are risk factors for IC in the young/middle-aged group;female,hypertension,diabetes,coronary heart disease and history of abdominal surgery are risk factors for IC in the elderly group. |
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