刘雪梅

【摘要】 目的 分析溃疡性结肠炎(UC)活动期的临床疗效及治疗转归，评价预后相关因素。方法 回顾性分析216例住院患者的病例资料，记录临床表现及诊疗经过，对柳氮磺吡啶(SASP)或5-氨基水杨酸(5-ASA)、糖皮质激素、免疫抑制剂、灌肠、外科手术等治疗方法的疗效进行评价。结果 活动期UC患者中，轻度占25．0%(54/216)，中度占50．9%(110/216)，重度占24．1% (52/216)；SASP或5-ASA是控制症状的主要药物，对于中度UC患者，联合用药治疗效果较为理想。而发病年龄轻、结肠病变范围大、低血红蛋白、大便以血为主、低血清白蛋白、病变伴有溃疡是提示疗效差的相关因素。结论 对于UC病变处于活动期时，应及时评估病情严重程度，选择疗效相对较好的治疗方案，并分析影响疗效相关因素。

【关键词】结肠炎；溃疡性；治疗结果；评价研究

Evaluation of the clinical curative effects on active ulcerative colitis

LIU Xue-mei.The Central Peoples Hospital of Zhumadian City.Henan 463000,China

【Abstract】 Objective To evaluate the curative effect and transformation of active ulcerative colitis,and to find out the relating factors indicating its curative effect and prognosis.Methods A retrospective study was performed on the clinical features,diagnosis and treatments of 216 patients in our hospital, and the curative effects of SASP/5-ASA, glucocorticoid, clysis, immunosuppressor as well as surgical operation were evaluated.Results Among all the active ulcerative colitis patients, 25．0%(54/216)were with mild changes,50．9% (110/216) were moderate,and the rest 24．1% (52/216)were severe.SASP/5-ASA were the chief symptom-controling agents, and the combination of two were more effective for especially the moderate ulcerativecolitis. Early onsetage, large area of colon changes, low hematoglobin, bloody stool, low serum albumin and ulcerative changes were shown to be the indications of poor curative effects.Conclusion A timely assessment, choice of appropriate therapies, and analysis on effect-relating factors were extremely important to the management of active ulcerative colitis.

【Key words】Colitis;Ulcerative;Treatment outcome;Evaluation studies

溃疡性结肠炎(ulcerative colitis，UC)是一种病因未明，并以直肠黏膜和黏膜下炎性反应病变为主要特征的慢性疾病，其临床表现往往直接反映结肠的病理改变。病变部位主要位于直肠、乙状结肠，也可扩展至结肠其他部位。文献报道约30%的活动期UC患者，药物治疗效果不理想。5%~10%的活动期UC患者需手术治疗^[1]。本文分析活动期UC患者的临床治疗经过及转归，并对一些预后指标进行评价。

1 临床资料

1．1 一般资料 1998-2007年本院住院收治的活动期UC患者216例。其中轻度54例，占25．0%；中度110例，占50．9%；重度52例，占24．1%。全部病例经结肠镜显示，可见病变处血管透视消失，易出血，伴有/无糜烂、溃疡(活动期的内镜下表现)。216例活动期UC患者中，男110例，女106例，男女比例为1．03C∶C1，平均37．8 (16～68)岁；……