Hiwatashi N, Yamazaki H, Kimura M, Morimoto T, Watanabe H, Toyota T
Third Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.
Gastroenterol Jpn. 1991 Jun;26(3):312-8. doi: 10.1007/BF02781919.
The course and prognosis of 308 patients with ulcerative colitis who visited Tohoku University Hospital during the period from 1954 to 1987 were investigated. Based these investigations, the following results were obtained. 1) In 27.6% of patients with proctitis, extension to the proximal colon developed during the observation period. 2) Surgical intervention was necessary in 33.9% of patients with total colitis and in 9.7% of those with left-sided colitis. 3) Of 1,566 patient-years in which the course was observed, 988 (63.1%) were active-years. When the course of ulcerative colitis was analyzed according to the duration and extent of involvement, the frequency of the attack-years in patients with proctitis or left-sided colitis steadily decreased with time. However, that of total colitis was constant, 65-85%, regardless of the follow-up period. Patients younger than age 20 at onset were prone to relapse during their course, compared with patients older than 20. 4) Ten patients died from causes related to ulcerative colitis in our hospital: 5 of them due to postoperative complications. Two patients developed colorectal cancer accompanying ulcerative colitis. 5) With respect to the cumulative survival rate, the 95% confidence limits of the observed curve was lower than the expected curve during the first 2 years and 12-16 years after the onset. The main causes of death were postoperative complications in the former and unrelated deaths of older patients in the latter.
对1954年至1987年期间就诊于东北大学医院的308例溃疡性结肠炎患者的病程及预后进行了调查。基于这些调查，得出了以下结果。1）在直肠炎患者中，27.6%在观察期内病变扩展至近端结肠。2）全结肠炎患者中有33.9%、左侧结肠炎患者中有9.7%需要进行手术干预。3）在观察病程的1566患者年中，988（63.1%）为活动期年。当根据受累的持续时间和范围分析溃疡性结肠炎的病程时，直肠炎或左侧结肠炎患者发作年的频率随时间稳步下降。然而，全结肠炎患者的发作年频率保持恒定，为65 - 85%，与随访期无关。发病时年龄小于20岁的患者在病程中比20岁以上的患者更容易复发。4）我院有10例患者死于与溃疡性结肠炎相关的原因：其中5例死于术后并发症。2例患者发生了与溃疡性结肠炎相关的结直肠癌。5）关于累积生存率，观察曲线的95%置信区间在发病后的前2年以及发病后12 - 16年低于预期曲线。前者主要死亡原因是术后并发症，后者主要是老年患者的非相关性死亡。
