老年人缺血性结肠炎50例临床特点分析

摘要

Objective To investigate the clinical characteristics and risk factors of ischemic colitis of elderly patients. Methods Sixty -four patients were divided into two groups according to their age. Clinical data of 50 elderly ischemic patients were retrospectively analyzed and were compared with those of 14 adult patients. Results (1)Most patients of ischemic colitis presented with abdominal pain, bloody stools and diarrhea. The difference was not sig nificant. (2)Colonoscopy showed lesions mainly occurred in the left colon, with mucosal congestion, edema, erosion, ulceration. The difference between two groups was not significant. (3)lschemic colitis usually occurred in elderly who complicated often with some basic diseases such as coronary heart disease, hypertension, diabetes. Positive medical treatment meant good prognosis. (4)Plasma concentration of hemoglobin and albumin were lower than the control group. The difference between two groups was significant ( P < 0. 01 ) . Level of plasma C - reactive protein ( CRP )Was higher than the the control group. The difference between two groups was significant ( P <0. 05 ) . Conclusion The Elderly patients of ischemic colitis presented with abdominal pain, bloody stool and diarrhea. Colonoscopy showed lesions mainly occurred in the left colon. Atherosclerosis related diseases, anemia hypoalbuminemia are the risk factors of ischemic colitis in the elderly. High level of CRP probably is a risk factor for 1C.%目的 探讨老年人缺血性结肠炎临床特点和易患因素.方法 64例缺血性结肠炎患者根据年龄分为老年组50例(年龄≥60岁)和对照组14例(年龄＜60岁).回顾分析临床资料,并进行组间比较.结果 ①多数患者表现为腹痛、便血、腹泻三联征,两组腹痛、血便、腹泻症状发生率比较无显著差异;②结肠镜下以黏膜充血、水肿、糜烂、溃疡等为主要表现,病变主要发生于左半结肠,两组间病变部位比较无显著差异;③缺血性结肠炎好发于老年患者,多伴有冠心病高血压、糖尿病等基础疾病,多数患者预后良好;④老年组患者的血红蛋白(Hb)、血清白蛋白(Alb)浓度低于对照组,差异有显著性(P<0.01),老年组C反应蛋白(CRP)水平高于对照组,差异有显著性(P<0.05).结论 老年缺血性结肠炎临床表现主要为腹痛、便血、腹泻;病变部位主要累及左半结肠.动脉粥样硬化相关性疾病是老年缺血性结肠炎的好发因素.贫血、低白蛋白血症是缺血性结肠炎重要的危险因素.CRP增高提示炎症反应也可能是老年人缺血性结肠炎的危险因素.