An analysis of clinical characteristics and risk factors for ulceration in ischemic colitis
10.3760/cma.j.issn.0578-1426.2014.08.011
- VernacularTitle:缺血性结肠炎溃疡形成的危险因素及临床特点分析
- Author:
Wenhui LIU
;
Liang LIAO
;
Hui SHI
;
Benyan WU
;
Xiaodong LI
;
Yan LIU
- Publication Type:Journal Article
- Keywords:
Colitis,ischemic;
Ulcer;
Aspirin;
Constipation;
Risk factors
- From:
Chinese Journal of Internal Medicine
2014;53(8):626-630
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical manifestations and risk factors related to ulcer in patients with ischemic colitis(IC).Methods Clinical data of sixty-three IC patients with definite diagnosis from June 2002 to June 2012 in the PLA General Hospital were retrospectively analyzed.All patients were classified into ulcer group (23 cases) and non-ulcer group (40 cases) according to the presence of ulcer or not.Clinical manifestations and risk factors related to ulcer lesions were compared in the two groups.Logistic regression model was used for statistical analysis.Results There were 50 men and 13 women enrolled,with an average age of 70 years old.The main clinical manifestations included abdominal pain [85.7％ (54/63)],diarrhea [54.0％ (34/63)],hematochezia [41.3％ (26/63)].In comparison with non-ulcer group,the ulcer group showed higher incidences of chronic constipation[34.8％ (8/23)vs 12.5％ (5/40),P =0.03],enteric-coated aspirin intake [52.2％ (12/23) vs 25.0％ (10/40),P =0.03] and abdomen tenderness[82.6％ (19/23) vs 52.5％ (21/40),P =0.02].Chronic constipation and entericcoated aspirin intake were independent risk factors related to ulcer lesions (OR =3.38,P =0.04 ; OR =5.91,P =0.03).Patients with abdomen tenderness had higher incidence of ulcer lesion(OR =3.12,P =0.04).The most common location of IC was left colon[69.8％ (44/63)].No difference of site distribution was found in ulcer and non-ulcer group(P =0.066).Splanchnic atherosclerosis in the ulcer group was more common than in non-ulcer group [88.2％ (15/17) vs 58.3％ (14/24),P =0.038].The duration of hospitalization was significantly longer in ulcer group [(14.3 ± 7.1) d vs (6.2 ± 4.1) d,P ＜ 0.01].Higher white blood cell (WBC) count and lower hemoglobin (Hb) were seen in ulcer group than those in non-ulcer group [(10.17 ±3.32) × 109/L vs (7.25 ±3.15) × 109/L,P =0.018; (98 ±27)g/L vs (126 ±35)g/L,P=0.041].Conclusions Chronic constipation,enteric-coated aspirin intake and splanchnic atherosclerosis are risk factors related to ulcer in IC patients.Abdomen tenderness,high WBC and low Hb strongly indicate possible IC with ulcer.
