Colussi Dora, Salari Behzad, Stewart Kathleen O, Lauwers Gregory Y, Richter James R, Chan Andrew T, Ricciardiello Luigi, Khalili Hamed
Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School , Boston MA , USA.
Scand J Gastroenterol. 2015;50(11):1382-8. doi: 10.3109/00365521.2015.1050692. Epub 2015 May 21.
Collagenous colitis (CC) and lymphocytic colitis (LC) are chronic inflammatory disorders of the colon. There is a paucity of data on differences in etiology, natural history, and treatment response between CC and LC.
Between 2002 and 2013, we identified new diagnoses of CC and LC using the Research Patient Data Registry in a tertiary referral center. We used chi square or Fischer's exact test and Wilcoxon rank-sum tests to compare the differences in clinical characteristics, treatment types, and response rates between LC and CC.
Through 2013, we confirmed 131 patients with a new diagnosis of microscopic colitis (MC) (55 LC, 76 CC). Compared to cases of LC, patients with a diagnosis of CC were more likely to be women (86% vs. 69%, p = 0.03), have elevated erythrocyte sedimentation rate (mean 28 vs. 13 mm/h, p = 0.04), and less likely to be diabetic (5% vs. 18%, p = 0.02). Budesonide was the most effective treatment for both CC and LC (94% and 80%, respectively). However, there were no statistically significant differences in response to various treatments according to the type of MC (all p > 0.10). Older age at the time of diagnosis was associated with better response to bismuth subsalicylate (odds ratio: 1.76; 95% confidence interval: 1.21-2.56 for every 5-year increase) for both CC and LC.
Despite differences in the clinical characteristics, response rates to available treatments appeared to be similar in both LC and CC. Older patients may have a better response to bismuth subsalicylate therapy.
胶原性结肠炎（CC）和淋巴细胞性结肠炎（LC）是结肠的慢性炎症性疾病。关于CC和LC在病因、自然病史及治疗反应方面的差异，数据较少。
2002年至2013年期间，我们在一家三级转诊中心利用研究患者数据登记系统确定了CC和LC的新诊断病例。我们使用卡方检验或费舍尔精确检验以及威尔科克森秩和检验来比较LC和CC在临床特征、治疗类型及反应率方面的差异。
截至2013年，我们确诊了131例新诊断的显微镜下结肠炎（MC）患者（55例LC，76例CC）。与LC患者相比，CC诊断患者更可能为女性（86%对69%，p = 0.03），红细胞沉降率升高（平均28对13 mm/h，p = 0.04），且患糖尿病的可能性较小（5%对18%，p = 0.02）。布地奈德是CC和LC最有效的治疗药物（分别为94%和80%）。然而，根据MC类型，对各种治疗的反应在统计学上无显著差异（所有p>0.10）。诊断时年龄较大与CC和LC对次水杨酸铋的反应较好相关（优势比：1.76；每增加5岁的95%置信区间：1.21 - 2.56）。
尽管临床特征存在差异，但LC和CC对现有治疗的反应率似乎相似。老年患者可能对次水杨酸铋治疗反应更好。
