Risk factors of appendiceal orifice inflammatory in patients with ulcerative colitis and prognosis analysis

doi:10.11958/20221581

Abstract

Abstract:

Objective To analyze the risk factors of appendiceal orifice inflammation (AOI) in patients with ulcerative colitis (UC) and the influence of AOI on the prognosis of UC. Methods A total of 288 UC patients were enrolled, of them 105 were AOI positive and 183 were AOI negative. The medical records of UC patients who underwent colonoscopy and treatment in the department of colorectal surgery were collected, and data including gender, age, medical history, colonoscopic lesion involvement and Mayo endoscopic subscore, microscopic pathological features and treatment. All patients were divided into two groups according to AOI. The demographics and endoscopic features of the two groups were analyzed. Logistic regression was used to analyze risk factors of AOI in UC patients. Kendall grade correlation was used to analyze the correlation between AOI inflammatory grade and rectal inflammatory grade in AOI-positive UC patients. Results There were no significant differences in age, gender and clinical classification between the two groups. There were significant differences in the scope of lesion involved and Mayo endoscopic subscore between the two groups (P<0.05). Multivariate Logistic regression analysis showed that wide lesion involvement and higher Mayo endoscopic subscore were independent risk factors for AOI (P<0.05). In AOI-positive UC patients, the grade of AOI pathological inflammation was positively correlated with the grade of rectal pathological inflammation (r_s=0.512, P<0.05). After treatment, most patients achieved remission, and there was no significant difference in the therapeutic effect between AOI positive and AOI negative patients. According to the treatment methods, AOI positive patients with proctitis were divided into the suppository drug group and the suppository combined with oral drug group, and the remission rate was higher in the suppository combined with oral drug group than that of the suppository drug group (P<0.05). Conclusion The wider the scope of endoscopic lesion involvement and the higher the Mayo endoscopic subscore in UC patients, the more likely AOI positive is. The evaluation of AOI under the colonoscopy is beneficial to better guide the treatment of UC patients.

Key words: colitis, ulcerative, colonoscopy, appendiceal orifice inflammation, skip lesion, Montreal classification, Mayo endoscopic subscore

CLC Number:

R656.9

Figures/Tables 9

References 18

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组别			n	性别					年龄（岁）
组别			n	男		女			年龄（岁）
AOI阳性			105	56（53.3）		49（46.7）			49.47±15.09
AOI阴性			183	117（63.9）		66（36.1）			47.69±15.07
χ²或t				3.126					0.963
组别		年龄					类型
组别		≤40岁			>40岁		初发型			慢性复发型
AOI阳性		36（35.0）			69（65.0）		50（47.6）			55（52.4）
AOI阴性		67（37.3）			116（62.7）		108（59.0）			75（41.0）
χ²		1.570					3.500
组别	累及范围						Mayo内镜评分
组别	E1		E2		E3		1分	2分		3分
AOI阳性	37（35.2）		20（19.0）		48（45.7）		21（20.0）	41（39.0）		43（41.0）
AOI阴性	117（63.9）		58（31.7）		8（4.4）		78（42.6）	75（41.0）		30（16.4）
Z	6.835^**						3.165^*

组别			n	性别					年龄（岁）
组别			n	男		女			年龄（岁）
AOI阳性			105	56（53.3）		49（46.7）			49.47±15.09
AOI阴性			183	117（63.9）		66（36.1）			47.69±15.07
χ²或t				3.126					0.963
组别		年龄					类型
组别		≤40岁			>40岁		初发型			慢性复发型
AOI阳性		36（35.0）			69（65.0）		50（47.6）			55（52.4）
AOI阴性		67（37.3）			116（62.7）		108（59.0）			75（41.0）
χ²		1.570					3.500
组别	累及范围						Mayo内镜评分
组别	E1		E2		E3		1分	2分		3分
AOI阳性	37（35.2）		20（19.0）		48（45.7）		21（20.0）	41（39.0）		43（41.0）
AOI阴性	117（63.9）		58（31.7）		8（4.4）		78（42.6）	75（41.0）		30（16.4）
Z	6.835^**						3.165^*

变量	β	SE	Wald χ²	P	OR	OR95%CI
性别	-0.439	0.249	3.110	0.078	0.645	0.395~1.050
年龄	0.102	0.256	0.160	0.692	1.107	0.672~1.840
临床类型	0.460	0.247	3.480	0.062	1.584	0.978~2.574
累及范围
E2 vs. E1	0.087	0.321	0.073	0.787	1.090	0.574~2.030
E3 vs. E1	2.943	0.426	47.748	<0.001	18.973	8.641~46.691
Mayo内镜评分
2分 vs. 1分	0.708	0.313	5.112	0.024	2.030	1.109~3.803
3分 vs. 1分	1.672	0.342	23.893	<0.001	5.324	2.758~10.583

变量	β	SE	Wald χ²	P	OR	OR95%CI
性别	-0.439	0.249	3.110	0.078	0.645	0.395~1.050
年龄	0.102	0.256	0.160	0.692	1.107	0.672~1.840
临床类型	0.460	0.247	3.480	0.062	1.584	0.978~2.574
累及范围
E2 vs. E1	0.087	0.321	0.073	0.787	1.090	0.574~2.030
E3 vs. E1	2.943	0.426	47.748	<0.001	18.973	8.641~46.691
Mayo内镜评分
2分 vs. 1分	0.708	0.313	5.112	0.024	2.030	1.109~3.803
3分 vs. 1分	1.672	0.342	23.893	<0.001	5.324	2.758~10.583

变量	β	SE	Wald χ²	P	OR	OR95%CI
累及范围
E2 vs. E1	0.046	0.333	0.019	0.890	1.047	0.539~1.998
E3 vs. E1	2.847	0.437	42.406	<0.001	17.235	7.665~43.266
Mayo内镜评分
2分 vs. 1分	0.499	0.358	1.946	0.163	1.647	0.822~3.362
3分 vs. 1分	1.486	0.384	15.008	<0.001	4.420	2.108~9.537
常数项	-1.736	0.296	34.328	<0.001	0.176