Lower prevalence of diverticulosis in patients with ulcerative colitis
Lower prevalence of diverticulosis in patients with ulcerative colitis
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DOI：
10.1007/s10350-007-0218-5
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发表时间：
2007-08-01
影响因子：
3.9
通讯作者：
Castiglione, Fabiana
中科院分区：
文献类型：
--
作者：
Rispo, Antonio;Pasquale, Luigi;Castiglione, Fabiana
目的：结肠憩室病的特征是肠壁异常增厚，与管腔超压和乙状结肠收缩力增加有关。然而，溃疡性结肠炎患者表现出慢性炎症改变，导致肠壁肌张力和收缩力降低。因此，我们可以假设溃疡性结肠炎和结肠憩室病是两种病理生理学上相互排斥的疾病。本研究旨在评估溃疡性结肠炎患者与对照内镜人群相比结肠憩室病的患病率。 方法：我们前瞻性分析了 85 名年龄大于 45 岁、患有已知溃疡性结肠炎的患者与 85 名年龄/性别匹配的无结肠炎患者的结肠憩室病患病率。所有患者均接受全结肠镜检查，并通过内镜检查和组织病理学诊断为溃疡性结肠炎和结肠憩室病。根据诊断时的年龄（< 30 岁、30 - 45 岁、> 45 岁）和疾病范围（乙状结肠炎、左侧结肠炎、广泛性结肠炎），溃疡性结肠炎患者也分为三个亚组。 结果：85 名患有溃疡性结肠炎的患者中有 7 名患有结肠憩室病，24 名没有患有溃疡性结肠炎的患者则有 24 名患有结肠憩室病（分别为 8.2% 和 28.2%；P < 0.001；相对风险，3.4；95% 置信区间，1.56 - 7.52）。所有 7 名患有这两种疾病的患者均在 45 岁以上时被诊断为溃疡性结肠炎。两组之间憩室的延伸程度没有差异。结论：溃疡性结肠炎患者的结肠憩室病患病率显着较低，这一发现可能反映了慢性肠壁炎症引起的运动改变。在发病较晚的溃疡性结肠炎患者中，结肠憩室病患病率的降低并不明显。
PURPOSE: Colonic diverticulosis is characterized by abnormal thickening of the bowel wall, associated with luminal overpressure and increase of sigmoid contractility. However, patients with ulcerative colitis show chronic inflammatory alterations determining a reduction of both bowel wall muscle tone and contractility. Thus, we could presume ulcerative colitis and colonic diverticulosis as two pathophysiologically and mutually excluding diseases. This study was designed to evaluate the prevalence of colonic diverticulosis in patients with ulcerative colitis compared with a control endoscopic population.METHODS: We prospectively analyzed the prevalence of colonic diverticulosis in 85 patients, older than aged 45 years, with known ulcerative colitis compared with that in 85 age/ gender-matched patients without colitis. All patients underwent pancolonoscopy with ulcerative colitis and colonic diverticulosis diagnosis made by endoscopy and histopathology. The patients with ulcerative colitis also were divided in three subgroups according to the age at diagnosis (< 30 years, 30 - 45 years, > 45 years) and extension of disease ( sigmoiditis, left colitis, extensive colitis).RESULTS: Colonic diverticulosis was present in 7 of 85 patients with and in 24 patients without ulcerative colitis ( 8.2 vs. 28.2 percent; P < 0.001; relative risk, 3.4; 95 percent confidence interval, 1.56 - 7.52). All seven patients with both diseases were diagnosed with ulcerative colitis when older than age 45 years. No differences were found between the two groups in terms of extension of diverticula.CONCLUSIONS: Patients with ulcerative colitis show a significantly lower prevalence of colonic diverticulosis, with this finding probably reflecting the motor alterations caused by chronic bowel wall inflammation. In the patients affected by ulcerative colitis with late onset of the disease, the reduced prevalence of colonic diverticulosis is not evident.