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有感染和无感染的溃疡性结肠炎患者的临床及病理特征;一项观察性研究。

Clinical and Pathological Features of Ulcerative Colitis in Patients with and without Infection; An Observational Study.

作者信息

Aletaha Najmeh, Dadvar Zohreh, Salehi Babak, Ketabi Moghadam Pardis, Niksirat Ali, Jowkar Akram, Taslimi Reza, Allameh Seyed Farshad, Ebrahimi Daryani Naser

机构信息

Division of Gastroenterology and Hepatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran.

Division of Gastroenterology and Hepatology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Middle East J Dig Dis. 2019 Jan;11(1):17-23. doi: 10.15171/mejdd.2018.123. Epub 2018 Nov 20.

Abstract

BACKGROUND A dramatic rise in the rate of infection (CDI) in patients with inflammatory bowel disease (IBD) has been reported in recent years. METHODS In this observational case control study, 65 patients were included and were divided into two groups of IBD + CDI as case group and IBD without CDI as control group. RESULTS 35 patients who had positive test for were assigned to the case group. The control group consisted of 30 patients with negative test for . Pancolitis was seen in the cases more statistically significant than the controls and proctitis was seen more among the controls than the cases ( = 0.001). The cases were on immunosuppressive ( = 0.001) and antibiotic ( = 0.02) therapy more than the controls. Colonoscopic findings revealed more severe and extensive inflammation among the cases versus milder inflammation among the controls, but these differences were not statistically significant ( = 0.2). Colectomy was seen in 10% of controls and none of the cases and this difference was statistically significant ( value = 0.05). More fecal calprotectin were seen among the cases than the controls and this difference was statistically significant ( < 0.05) CONCLUSION This study showed more infection among the patients on antibiotic or immunosuppressive therapy. Pathological investigation revealed more severe and extensive inflammation among the cases than the controls. Cases had clinically more severe signs and symptoms with higher mayo scores than the controls. ESR (Erythrocyte sedimentation rate) and fecal calprotectin were higher in patients with positive infection and serum albumin was lower in such patients.

摘要

背景 近年来,有报道称炎症性肠病(IBD)患者的艰难梭菌感染(CDI)率急剧上升。方法 在这项观察性病例对照研究中,纳入了65名患者,分为IBD + CDI病例组和无CDI的IBD对照组。结果 35名检测呈阳性的患者被分配到病例组。对照组由30名检测呈阴性的患者组成。病例组全结肠炎的发生率在统计学上比对照组更显著,而对照组直肠炎的发生率高于病例组(P = 0.001)。病例组接受免疫抑制治疗(P = 0.001)和抗生素治疗(P = 0.02)的比例高于对照组。结肠镜检查结果显示,病例组的炎症比对照组更严重、更广泛,但这些差异无统计学意义(P = 0.2)。10%的对照组患者接受了结肠切除术,病例组无一例接受结肠切除术,这种差异具有统计学意义(P值 = 0.05)。病例组的粪便钙卫蛋白水平高于对照组,这种差异具有统计学意义(P < 0.05)。结论 本研究表明,接受抗生素或免疫抑制治疗的患者中艰难梭菌感染更多。病理检查显示,病例组的炎症比对照组更严重、更广泛。病例组的临床症状和体征比对照组更严重,梅奥评分更高。艰难梭菌感染阳性患者的红细胞沉降率(ESR)和粪便钙卫蛋白水平较高,血清白蛋白水平较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6c27/6488494/866f031c1c8e/mejdd-11-17-g001.jpg

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