Park Byoung Joon, Lee Kwang Jae, Hwang Jae Chul, Sin Sung Jae, Chung Jae Yeon, Cho Sung Won
Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea.
Korean J Gastroenterol. 2008 Jul;52(1):21-6.
BACKGROUND/AIMS: Ulcerative colitis (UC) is a chronic inflammatory bowel disease with heterogeneous clinical features. Data on the disease course and prognosis of UC patients who have been regularly treated are lacking. We aimed to investigate relapse rates of UC in remission and factors related to relapse.
We retrospectively analyzed clinical courses of 84 patients (43 males, median age 43 years, ranged 20-73 years) diagnosed as UC at Ajou University Hospital between January 1997 and December 2005 based on clinical, endoscopic and pathologic findings, and who were regularly followed for at least one year after the remission.
Study subjects consisted of 32 proctitis (38%), 21 left-sided colitis (25%), and 31 subtotal or total colitis (37%). Of 84 patients, relapse was observed in 52 patients (62%) during the follow-up period (ranged 1-9 years). The relapse rate was 24%, 41%, 51%, 65%, 71%, and 79% at 1 year, 2 years, 3 years, 4 years, 5 years and 6 years, respectively. Among sex, age, hemoglobin, ESR, and the extent of disease on admission, decrease of hemoglobin level was the only independent factor related to relapse (odds ratio=2.67, 95% CI (1.32-5.42), p<0.01).
In Korea, relapse of UC in remission is not rare. Decrease of hemoglobin level is an independent risk factor related to its relapse, while the extent of disease is not.
背景/目的:溃疡性结肠炎(UC)是一种具有异质性临床特征的慢性炎症性肠病。目前缺乏关于接受常规治疗的UC患者疾病进程和预后的数据。我们旨在调查缓解期UC的复发率及复发相关因素。
我们回顾性分析了1997年1月至2005年12月在阿朱大学医院根据临床、内镜和病理检查结果诊断为UC的84例患者(43例男性,中位年龄43岁,年龄范围20 - 73岁)的临床病程,这些患者在缓解后至少接受了一年的定期随访。
研究对象包括32例直肠炎(38%)、21例左侧结肠炎(25%)和31例次全结肠或全结肠炎(37%)。在84例患者中,随访期间(1 - 9年)有52例(62%)复发。1年、2年、3年、4年、5年和6年的复发率分别为24%、41%、51%、65%、71%和79%。在性别、年龄、血红蛋白、血沉以及入院时疾病范围这些因素中,血红蛋白水平下降是与复发相关的唯一独立因素(比值比 = 2.67,95%可信区间(1.32 - 5.4),p < 0.01)。
在韩国,缓解期UC复发并不罕见。血红蛋白水平下降是与其复发相关的独立危险因素,而疾病范围则不是。