Park S M, Han D S, Yang S K, Hong W S, Min Y I
Department of Internal Medicine, University of Ulsan, Seoul, Korea.
Korean J Intern Med. 1996 Jan;11(1):9-17. doi: 10.3904/kjim.1996.11.1.9.
This study was conducted to investigate the clinical features of ulcerative colitis in Korea and to evaluate the clinical course after medical therapy.
Symptoms, signs and results of the treatment were retrospectively analyzed in 66 patients (male 32, female 34) diagnosed to have ulcerative colitis at the Asan Medical Center.
The median age of the beginning of symptoms was 36 years (range, 14-72). Diarrhea and rectal bleeding were observed in 95.1 and 91.4%, respectively, at the time of diagnosis, while extra-colonic manifestations were observed in 24.1%. In 41 patients (62.1%), colitis developed in the rectum and sigmoid colon, while left colitis and extensive colitis developed in 11 (16.7%) and 14 patients (21.2%), respectively. The severity of disease was determined according to the clinical criteria, resulting in 22 (33.3%) mild, 21 (31.8%) moderate and 23 (34.8%) severe diseases. The seventy was also classified as 1, 2 and 3 by sigmoidocolonoscopic findings: 1;17 patients(25.8%), 2;27(40.9%) and 22(33.3%). Among 23 patients with severe disease, 5 patients (7.6%) received total colectomy due to toxic megacolon, intractability to medical therapy, ileocolic fistula and intestinal stenosis. The severity determined by colonoscopic findings was well correlated with that determined clinically and was closely related to the severity of symptoms, levels of albumin, hemoglobin and the count of leukocyte. The median duration of symptoms before treatment was 4 weeks (range, 11-300). All patients were treated with sulfasalazine and prednisolone. All patients with medical therapy, except 2 patients (96.7%), obtained clinical remission. The median days required for remission was 14 (range, 3-70). Relapse rates at 6 months, 1 year and 2 years after the initiation of treatment were 19.7, 34.1 and 49.3%, respectively. The median disease-free interval from the time of remission was 10 months (range, 2-60). After remission, the subsequent relapse rate increased in severe disease, while no difference was observed between the disease extents.
The general characteristics of clinical manifestations and clinical course, after the medical treatment of ulcerative colitis in Korean patients, are not considerably different from those in Western countries.
本研究旨在调查韩国溃疡性结肠炎的临床特征，并评估药物治疗后的临床病程。
对在峨山医学中心被诊断为溃疡性结肠炎的66例患者（男性32例，女性34例）的症状、体征及治疗结果进行回顾性分析。
症状开始出现的中位年龄为36岁（范围14 - 72岁）。诊断时，腹泻和直肠出血的发生率分别为95.1%和91.4%，而肠外表现的发生率为24.1%。41例患者（62.1%）的结肠炎发生在直肠和乙状结肠，左半结肠炎和广泛性结肠炎分别发生在11例（16.7%）和14例（21.2%）患者中。根据临床标准确定疾病严重程度，轻度22例（33.3%），中度21例（31.8%），重度23例（34.8%）。根据乙状结肠镜检查结果疾病严重程度也分为1、2和3级：1级17例（25.8%），2级27例（40.9%），3级22例（33.3%）。在23例重度疾病患者中，5例（7.6%）因中毒性巨结肠、药物治疗无效、回结肠瘘和肠道狭窄接受了全结肠切除术。结肠镜检查确定的严重程度与临床确定的严重程度密切相关，且与症状严重程度、白蛋白水平、血红蛋白水平及白细胞计数密切相关。治疗前症状的中位持续时间为4周（范围1 - 300周）。所有患者均接受柳氮磺胺吡啶和泼尼松龙治疗。除2例患者（96.7%）外，所有接受药物治疗的患者均获得临床缓解。缓解所需的中位天数为14天（范围3 - 70天）。治疗开始后6个月、1年和2年的复发率分别为19.7%、34.1%和49.3%。缓解后的无病间隔中位时间为10个月（范围2 - 60个月）。缓解后，重度疾病的后续复发率增加，而疾病范围之间未观察到差异。
韩国患者溃疡性结肠炎药物治疗后的临床表现和临床病程的一般特征与西方国家没有显著差异。
