[Clinical features of primary sclerosing cholangitis and inflammatory bowel disease].

X Y Cheng, R Jin, Y Y Yang, J Wang, J N Li
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Abstract

Objective: To explore disease characteristics of primary sclerosing cholangitis (PSC) and inflammatory bowel disease (IBD) and compare the differences between PSC with and without IBD. Methods: Study design was cross sectional. Forty-two patients with PSC who were admitted from January 2000 to January 2021 were included. We analyzed their demographic characteristics, clinical manifestations, concomitant diseases, auxiliary examination, and treatment. Results: The 42 patients were 11-74(43±18) years of age at diagnosis. The concordance rate of PSC with IBD was 33.3%, and the age at PSC with IBD diagnosis was 12-63(42±17) years. PSC patients with IBD had higher incidences of diarrhea and lower incidences of jaundice and fatigue than in those without IBD (all P<0.05). Alanine aminotransferase, total bilirubin, direct bilirubin, total bile acid and carbohydrate antigen 19-9 levels were higher in PSC patients without IBD than in those with IBD (all P<0.05). The positive rates for antinuclear antibodies and fecal occult blood were higher in PSC patients with IBD than in those without IBD (all P<0.05). Patients with PSC complicated with ulcerative colitis mainly experienced extensive colonic involvement. The proportion of 5-aminosalicylic acid and glucocorticoid application in PSC patients with IBD was significantly increased compared with that of PSC patients without IBD (P=0.025). Conclusions: The concordance rate of PSC with IBD is lower at Peking Union Medical College Hospital than in Western countries. Colonoscopy screening may benefit PSC patients with diarrhea or fecal occult blood-positive for early detection and diagnosis of IBD.

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【原发性硬化性胆管炎与炎症性肠病的临床特点】。
目的:探讨原发性硬化性胆管炎(PSC)与炎症性肠病(IBD)的疾病特点,比较PSC合并与不合并IBD的差异。方法:采用横断面设计。纳入2000年1月至2021年1月收治的42例PSC患者。我们分析了他们的人口学特征、临床表现、伴随疾病、辅助检查和治疗。结果:42例患者诊断时年龄11 ~ 74(43±18)岁。PSC与IBD的符合率为33.3%,PSC诊断为IBD的年龄为12-63(42±17)岁。合并IBD的PSC患者腹泻发生率高于未合并IBD的PSC患者,黄疸和疲劳发生率低于未合并IBD的PSC患者(均PPPP=0.025)。结论:北京协和医院PSC与IBD的符合率低于西方国家。结肠镜筛查可能有利于腹泻或粪便隐血阳性的PSC患者早期发现和诊断IBD。
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