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摘要: 目的:探讨缺血性肠炎(IC)临床特点、发病危险因素及炎症指标对判断预后的意义,为早期诊断、早期治疗、判断预后提供依据。方法:选取2008年1月—2020年2月经北京市某三级医院结肠镜及相关检查诊断为IC的患者72例为病例组,选取同期在该院接受健康体检、结肠镜检查未见异常的体检者100例为对照组。将2组的临床资料进行回顾性分析,比较2组患者的一般资料、临床特征、实验室检查、内镜下表现、预后及发病危险因素;同时比较病例组患者起病时与治疗后炎症指标的变化情况。结果:病例组患者的白蛋白、总胆固醇、高密度脂蛋白、活化部分凝血活酶时间水平低于对照组,白细胞、中性粒细胞、C反应蛋白(CRP)、纤维蛋白原、D-二聚体水平高于对照组,差异有统计学意义(P<0.05)。比较2组患者的发病危险因素,其中吸烟史、冠心病、高脂血症、脂肪肝、腹部手术史的单因素分析结果显示差异有统计学意义(P<0.05)。多因素分析提示吸烟史、冠心病、高脂血症是IC的独立危险因素。比较病例组起病时与治疗后炎症指标变化,发现治疗后白细胞及CRP水平明显下降,差异有统计学意义(P<0.05)。结论:IC多发生于合并有冠心病、高脂血症及有吸烟史的老年女性,会表现为白细胞、CRP、D-二聚体等指标显著升高,治疗过程中炎症指标较前下降或可提示疾病好转。Abstract: Objective: To explore the significance of ischemic colitis(ischemic colitis, IC) clinical characteristics, risk factors and inflammation indicators for prognosis, and provide evidence for early diagnosis, early treatment, and prognosis.Methods: Select 72 patients who were diagnosed as IC by colonoscopy and related examinations in a tertiary hospital in Beijing from January 2008 to February 2020 as the case group, and select 100 patients who underwent health examination in the same hospital during the same period and showed no abnormalities in colonoscopy as the control group. The clinical data of the case group and the control group were retrospectively analyzed, and the general data, clinical characteristics, laboratory examination, endoscopic performance, prognosis and risk factors of the two groups of patients were compared. At the same time, the changes of inflammation indexes in the ischemic enteritis group at onset and after treatment were compared.Results: The levels of albumin, total cholesterol, high-density lipoprotein, and activated partial thromboplastin time in the case group were lower than those in the control group, and the levels of white blood cells, neutrophils, C-reactive protein(CRP), fibrinogen, and D-dimer were higher than the control group, the difference was statistically significant(P<0.05). The risk factors of the two groups of patients were compared. The results of univariate analysis of smoking, coronary heart disease, hyperlipidemia, fatty liver, and abdominal surgery history showed statistical differences(P<0.05). Multivariate analysis suggests that smoking history, coronary heart disease, and hyperlipidemia are independent risk factors for ischemic colitis. Comparing the changes of inflammatory indexes in the ischemic enteritis group at onset and after treatment, it was found that the levels of white blood cells and CRP decreased significantly after treatment, and the difference was statistically significant(P<0.05).Conclusion: IC mostly occurs in elderly women with coronary heart disease and hyperlipidemia, who have a history of smoking in the past, and the clinical manifestations are not specific, and laboratory tests suggest that inflammation indicators such as leukocytes and CRP are increased, and D-dimer is increased. After the treatment, the decline in inflammation indicators may indicate disease improvement.
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Key words:
- ischemic colitis /
- clinical characteristics /
- risk factors /
- inflammation indicators
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