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慢性非血性腹泻:瑞典马尔默的一项前瞻性研究,重点关注显微镜下结肠炎。

Chronic non-bloody diarrhoea: a prospective study in Malmö, Sweden, with focus on microscopic colitis.

作者信息

Larsson Johanna K, Sjöberg Klas, Vigren Lina, Benoni Cecilia, Toth Ervin, Olesen Martin

机构信息

Department of Clinical Sciences, Department of Gastroenterology and Nutrition, Skåne University Hospital, Lund University, Malmö, Sweden.

出版信息

BMC Res Notes. 2014 Apr 14;7:236. doi: 10.1186/1756-0500-7-236.

Abstract

BACKGROUND

Chronic non-bloody diarrhoea affects up to 5% of the population. Microscopic colitis is one of the most common causes, encompassing the subtypes collagenous colitis and lymphocytic colitis. The diagnosis of microscopic colitis is made by histological examination of colonic mucosal biopsy specimens. The aim of this investigation was to determine whether laboratory parameters or questions about disease history or concomitant disease could be helpful in discriminating patients with MC from those with a histologically normal colonic mucosa.

FINDINGS

Patients admitted for colonoscopy because of chronic non-bloody diarrhoea (>2 loose stools for >3 weeks) at endoscopy units in Malmö during 2007 and 2009, were enrolled. A total number of 78 patients were included (60 women, 18 men, median age 59, IQR 45-69 years). Out of these 78, 15 patients (19%) had microscopic colitis (CC; n = 10, LC; n = 5). MC was especially prevalent in patients above the age of 50 (25%). No differences were found between those with normal histology and MC in laboratory analyses (inflammatory and liver parameters). Neither were differences shown in questions regarding symptoms, environmental factors or concomitant diseases except for an association with celiac disease (p = 0.019) and a trend maybe indicating an inverse association with appendectomy (p = 0.057).

CONCLUSIONS

Microscopic colitis is associated with female gender, celiac disease and consumption of NSAIDs. Trends were observed indicating that age above 50 years, acute onset and absence of appendectomy may be associated with MC. No associations were observed with other symptoms, calprotectin levels or liver parameters.

摘要

背景

慢性非血性腹泻影响着高达5%的人群。显微镜下结肠炎是最常见的病因之一,包括胶原性结肠炎和淋巴细胞性结肠炎亚型。显微镜下结肠炎的诊断通过结肠黏膜活检标本的组织学检查来进行。本研究的目的是确定实验室参数、疾病史问题或伴随疾病是否有助于区分显微镜下结肠炎患者与结肠黏膜组织学正常的患者。

研究结果

纳入了2007年至2009年期间因慢性非血性腹泻(内镜检查时>3周内每天>2次稀便)而在马尔默内镜检查单位接受结肠镜检查的患者。共纳入78例患者(60名女性,18名男性,中位年龄59岁,四分位间距45 - 69岁)。在这78例患者中,15例(19%)患有显微镜下结肠炎(胶原性结肠炎;n = 10,淋巴细胞性结肠炎;n = 5)。显微镜下结肠炎在50岁以上患者中尤为常见(25%)。在实验室分析(炎症和肝脏参数)中未发现组织学正常者与显微镜下结肠炎患者之间存在差异。在症状、环境因素或伴随疾病方面也未显示出差异,除了与乳糜泻有关(p = 0.019)以及可能存在与阑尾切除术呈负相关的趋势(p = 0.057)。

结论

显微镜下结肠炎与女性、乳糜泻和非甾体抗炎药的使用有关。观察到一些趋势表明,50岁以上、急性起病和未行阑尾切除术可能与显微镜下结肠炎有关。未观察到与其他症状、钙卫蛋白水平或肝脏参数之间存在关联。

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