Moayyeri Alireza, Daryani Naser Ebrahimi, Bahrami Hossein, Haghpanah Babak, Nayyer-Habibi Atoosa, Sadatsafavi Mohsen
Digestive Disease Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran.
J Gastroenterol Hepatol. 2005 Mar;20(3):366-70. doi: 10.1111/j.1440-1746.2005.03727.x.
We noticed in our practice that patients with ulcerative colitis (UC) who have developed primary sclerosing cholangitis (PSC) experience a milder course of colonic disease. Our objective in this study was to define whether or not there is any difference between UC activity and its course in patients with and without PSC.
Nineteen patients with UC and PSC (eight male, mean age 25 years) were enrolled. To every patient with UC and PSC, three patients with UC alone (total of 57 patients, 28 male, mean age 24 years) matched for age at onset, duration of the disease and extension of colonic disease were selected as the control group. We used number of hospitalizations due to activity of UC and number of short corticosteroid administrations in various years of follow-up as variables indicating course and severity of the colonic disease in this period. For comparing trends of UC activity between two groups, we used repeated measures two-way analysis of variances.
Mean duration of follow up in case and control groups was 12.2 +/- 5.7 and 11.4 +/- 4.9 years, respectively. Two groups had no significant difference in use of sulfasalzine or aminosalicylates. Number of hospitalizations and courses of steroid therapy because of UC activity decreased significantly over time (P < 0.000) in both groups, and it was significantly higher in controls than in cases (P = 0.045 and 0.032, respectively).
Development of PSC in patients with UC might have a positive effect on colonic disease. Further investigations to evaluate the basis of this improvement are warranted.
我们在临床实践中注意到，患有原发性硬化性胆管炎（PSC）的溃疡性结肠炎（UC）患者的结肠疾病病程较为温和。本研究的目的是确定患有和未患有PSC的UC患者在UC活动度及其病程方面是否存在差异。
纳入19例患有UC和PSC的患者（8例男性，平均年龄25岁）。对于每例患有UC和PSC的患者，选择3例年龄、病程和结肠疾病范围相匹配的单纯UC患者（共57例患者，28例男性，平均年龄24岁）作为对照组。我们将因UC活动导致的住院次数以及随访各年份中短期使用皮质类固醇的次数作为指示该时期结肠疾病病程和严重程度的变量。为比较两组之间UC活动度的趋势，我们采用重复测量双向方差分析。
病例组和对照组的平均随访时间分别为12.2±5.7年和11.4±4.9年。两组在使用柳氮磺胺吡啶或氨基水杨酸类药物方面无显著差异。两组中因UC活动导致的住院次数和类固醇治疗疗程均随时间显著减少（P<0.000），且对照组显著高于病例组（分别为P = 0.045和0.032）。
UC患者并发PSC可能对结肠疾病有积极影响。有必要进行进一步研究以评估这种改善的基础。
