The analysis of clinical characteristics and treatment of 234 patients with intractable ulcerative colitis / 中华消化杂志

ABSTRACT

Objective To investigate the clinical characteristics and currently treatment status of intractable ulcerative colitis (IUC). Methods A retrospective analysis was conducted on the data of inflammatory bowel disease patients, who were hospitalized in Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, from January 1999 to December 2009. According to the reaction to glucosteroids (GCS) treatment, they were divided into GCS effective group and intractable group. The general data, lesion, clinical symptoms and laboratory findings of these two groups were compared.Further treatments and the results of intractable group were analyzed. Results Totally 234 UC patients were enrolled, of which 37.6％ (88/234) patients received GCS treatment, intractable group and effective group took up 23.9％ (21/88) and 76.1％ (67/88) respectively. There was no significant difference of lesion between two groups (P＞0.05). Compared with effective group, the proportion of intractable group was higher in moderately severe bellyache[38. 1 ％ (8/21) vs 13. 4％ (9/67), P＝0.012, OR＝3.97, 95％CI1.29～12.23], anemia[61.9％(13/21) vs 32.8％(22/67), P＝0.018,OR＝3.32, 95％CI1.20～9.20], thrombocytosis[57.1％(12/21) vs 29.9％(20/67), P＝0.023,OR＝3.13, 95％ CI 1.14 ～8.61]and hypoalbuminemia[38.1 ％ (8/21) vs 11.9％ (8/67), P＝0.007, OR＝4.54, 95％CI 1.44～ 14.32]. Some patients of intractable group could be remission through extending period of GCS treatment, adding the immunomodulators or biological agents and intestinal segment excision. Conclusion UC patients with moderately severe bellyache, anemia,thrombocytosis, hypoalbuminemia at the onset of disease, which may indicate relatively poor response to GCS treatment. Immunomodulators, biological agents and surgery are the further treatment for IUC patients.