Department of Gastroenterology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu, 215004, China.
Acta Gastroenterol Belg. 2022 Apr-Jun;85(2):283-290. doi: 10.51821/85.2.9527.
Ischemic colitis (IC) is thought to occur more frequently in the elderly, but the incidence in young and middle-aged adults is increasing. This study determined the clinical characteristics of and risk factors for young and middle-aged IC patients.
The medical records of 190 IC patients from 2010-2020 were reviewed. The clinical features of the young and middle-aged IC group (group A, < 60 years [n=70]) were compared to the elderly IC (group B, ≥60 years [n=120]) and age- and gender-matched colon polyp groups (group C, <60 years [n=272]). Independent risk factors for IC in group A were assessed using multivariate logistic regression analysis.
There were no significant differences in groups A and B with respect to season of onset, symptoms, signs, treatment, or recurrences. The main symptoms of group A were abdominal pain (98.6%) and hematochezia (98.6%). Lesions commonly involved the left half of the colon (87.1%) and the clinical conditions were generally not severe. The percentage of patients with constipation (11.4% vs. 4.0%, P=0.034) and using a calcium channel antagonist (21.4% vs. 11.4%, P=0.028) was significantly higher in group A than group C. Regression analysis demonstrated that constipation (OR 2.831, P=0.037) and taking a calcium channel antagonist (OR 2.486, P=0.012) were closely associated with the occurrence of IC in group A.
Constipation and taking a calcium channel antagonist were independent risk factors for the onset of IC in young and middle-aged adults. Among young and middle-aged adults with abdominal pain and bloody stools who also have constipation or are taking a calcium channel antagonist to treat hypertension, the diagnosis of IC should be considered.
缺血性结肠炎（IC）被认为更常见于老年人，但在中青年人群中的发病率正在增加。本研究旨在确定中青年 IC 患者的临床特征和危险因素。
回顾了 2010 年至 2020 年期间 190 例 IC 患者的病历。比较了中青年 IC 组（A 组，<60 岁[n=70]）与老年 IC 组（B 组，≥60 岁[n=120]）和年龄及性别匹配的结肠息肉组（C 组，<60 岁[n=272]）的临床特征。采用多变量逻辑回归分析评估 A 组中 IC 的独立危险因素。
A 组和 B 组在发病季节、症状、体征、治疗或复发方面无显著差异。A 组的主要症状为腹痛（98.6%）和血便（98.6%）。病变常累及左半结肠（87.1%），临床情况通常不严重。A 组便秘（11.4%比 4.0%，P=0.034）和使用钙通道拮抗剂（21.4%比 11.4%，P=0.028）的患者比例明显高于 C 组。回归分析表明，便秘（OR 2.831，P=0.037）和使用钙通道拮抗剂（OR 2.486，P=0.012）与 A 组 IC 的发生密切相关。
便秘和使用钙通道拮抗剂是中青年发生 IC 的独立危险因素。对于出现腹痛和血便且伴有便秘或使用钙通道拮抗剂治疗高血压的中青年患者，应考虑 IC 的诊断。
