| Objective The clinical characteristics of patients with ischemic colitis were retrospectively studied,and the differences in characteristics between the young and middle-aged group and the elderly group were compared,then the risk factors of IC were explored,in order to improve the clinical diagnosis and treatment of the disease.Methods1.The clinical data of 134 patients with IC who were hospitalized and first diagnosed in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2022 were retrospectively analyzed and divided into in the young and middle-aged group(<60 years old,46 cases)and in the elderly group(≥60 years old,88 cases)according to their age,and the differences in clinical characteristics between the two groups were compared.2.134 patients with IC who were hospitalized and first diagnosed in the First Affiliated Hospital of Anhui Medical University from January 2018 to January 2022 were selected as the case group.134 patients who had completed colonoscopy to confirm colon polyps and with age and gender matching the IC group at the same period were randomly selected as the control group.The relevant clinical data were collected,and then statistical methods such as univariate and multifactor regression were used to study the risk factors of IC.Results1.The male-to-female ratio was 1:2.94 and the mean age was(64.98±12.03)years in134 patients,and the peak age of onset was 60-69 and 70-79 years.The male-to-female ratio was 1:2.54 in the middle-aged group and 1:3.19 in the elderly group,both of which were more common in women.2.75.4% of the patients had concomitant diseases,and the most common diseases were hypertension(36.6%),history of abdominal surgery(28.4%)and arrhythmia(23.1%).49.3% of the patients take medicine,and oral antihypertensive drugs(32.1%),aspirin(12.7%)and hypoglycemic drugs(10.4%)were the most common.The proportion of young and middle-aged group with hypertension,coronary artery disease,arrhythmia and oral antihypertensive drugs was lower than those of the older group,while the proportion of abdominal surgery history was higher than that of the older group,and the difference was significant(all P < 0.05).3.The typical clinical symptoms were abdominal pain(96.3%),hematochezia(92.5%)and diarrhea(65.7%).There were nausea(33.6%),vomiting(28.4%),abdominal distention(13.4%),dizziness and weakness(5.2%),decreased defecation(4.5%)and fever(2.2%)in some patients.The site of abdominal pain was more common in the lower abdomen(41%)and left lower abdomen(18.7%).There was no significant difference in the clinical symptoms between the two groups of patients.4.Laboratory tests included 51 cases of elevated leukocytes(51/134,38.1 %),82 cases of elevated neutrophil percentage(82/134,61.2 %),25 cases of albumin <35 g(25/132,18.9 %),64 cases of elevated C-reactive protein(64/101,63.4 %),98 cases of elevated D-dimer(98/125,78.4 %),and 110 cases with positive fecal occult blood(110/123,89.4%).The hemoglobin,glomerular filtration rate,albumin,and sodium levels of middle-aged and young group were higher than those of the older group,while the percentage of neutrophils,D-dimer,C-reactive protein,urea nitrogen levels,and the percentage of positive fecal occult blood were lower than those of the older group,and the differences were statistically significant(all P < 0.05).5.The colonoscopy show different degrees of severity of colon mucosal congestion(96.3%),edema(70.9%),erosion(47%),bleeding(38.8%),ulceration(25.4%),and stricture(8.2%),etc.There were 109 cases(81.3%)of the transient type,2 cases(1.5%)of the gangrenous type,and 23 cases(17.2%)of the stricture type.The left colon was involved in 112 cases(83.6%),with the sigmoid colon(81.3%)and descending colon(61.2%)being the most common.The differences in endoscopic typing and distribution sites between the two groups were not statistically significant.Pathology mostly indicated mucosal inflammation(85.7%).6.The positive rate of abdominal vascular ultrasound was 24%,and the positive rate of abdominal CT was 69.6%,and the positive rate of abdominal CTA was 56.8%.The positive rate of abdominal CTA was significantly higher in the elderly group than that of the young and middle-aged group,and the involvement of the abdominal aorta and mesenteric artery was also significantly higher than those of the young and middle-aged group,and the difference was significant(all P < 0.05).7.Conservative medical treatment was mostly given after admission.The prognosis was good in 131 cases(97.8%),while one young and middle-aged patient underwent surgery due to partial colonic necrosis,and another elderly patient gave up treatment due to multiple organ failure,and one elderly patient underwent surgery due to superior mesenteric artery thrombosis.Isolated right colon ischemia(IRCI)is one of the poor prognostic factors.8.Univariate analysis revealed statistical differences between the case group and the control group in hypertension,diabetes,coronary artery disease,cerebrovascular disease,history of abdominal surgery,antihypertensive drugs,hypoglycemic drugs,antiplatelet agents,leukocytes,percentage of neutrophil,D-dimer,prothrombin time,activated partial thromboplastin time,fibrinogen,fibrin degradation products,and glomerular filtration rate.Multifactorial analysis identified neutrophil percentage,activated partial thromboplastin time and history of abdominal surgery as independent risk factors.Conclusion1.Female were more common in IC patients,and IC was mostly combined with underlying diseases.The proportion of young and middle-aged group with underlying diseases was lower than those of the elderly group,while the proportion of abdominal surgery history was higher than that of the elderly group.The elderly group was closely related to vascular factors.2.Colonoscopy had relatively specific manifestations,while the laboratory and imaging tests are not specific.3.Patients with isolated right colon ischemia have a poorer prognosis.4.Multifactorial analysis showed that history of abdominal surgery,percentage of neutrophils and activated partial thromboplastin time were independent risk factors for IC. |
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