| 特集名 | 潰瘍性大腸炎の治療の最先端 | |
|---|---|---|
| 題名 | 潰瘍性大腸炎の経過 | |
| 発刊年月 | 1997年 09月 | |
| 著者 | 宇都宮 利善 | 篠原外科・整形外科 |
| 著者 | 北洞 哲治 | 国立大蔵病院臨床研究部 |
| 【 要旨 】 | 発病率は1960～1975年に急激に増加し，1975年以後は横ばい状態である．比較的長期にわたる経過は1985年までに発病した2,066例において，治療中39.8%，手術0.5%，緩解中18.2%，受診せず40.8%，死亡0.7%である． 罹患範囲の口側進展は直腸炎の31.5%が左側大腸炎に，6.8%が全大腸炎に，また，左側大腸炎の16.5%が全大腸炎に進展している． 合併した大腸炎は10,165例中60例，0.6%に認められた．本疾患発病の平均年齢は39.1歳，大腸癌発現の平均年齢は50.2歳であり，発病後癌発現までの平均期間は12.3年である．癌の占拠部位は直腸に多く，癌発生前の病型は全大腸炎が多い．本疾患全体の死亡率は3.0%であり，全大腸炎の死亡率は4.9%と高い． |
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| Theme | Advanced Therapy Ulcerative Colitis | |
|---|---|---|
| Title | Clinical Course of Ulcerative Colitis | |
| Author | Toshiyoshi Utsunomiya | Shinohara Surgical Clinic |
| Author | Tetsuji Kitahora | Institute of Clinical Research, National Ohkura Hospital |
| [ Summary ] | The clinical course of ulcerative colitis (UC) was analyzed epidemiologically. The annual incidence of ulcerative colitis increased rapidly between 1960 and 1975, and has tended to remain at the same level since 1975. Of 2,066 longstanding patients whose onset was before 1985, 823(39.8%) are now under medical treatment, 377(18.2%) are in remission not requiring treatment, 14(0.7%) are decreased, 10(0.5%) have undergone surgery, and the outcomes of 842 patients(40.8%) are unknown. Involvement of the more proximal colon occurred in 38.3% of patients with proctitis, extending to left-sided colitis in 31.5% and to total colitis in 6.8%. Colorectal cancer developed in 60(0.6%) of 10,165 patients with UC. The mean age of onset of global UC was 39.1 years old and that of UC patients diagnosed with colorectal cancer was 50.2 years old. The average period from the onset of UC to the diagnosis of colorectal cancer was 12.3 years. Colorectal cancers in patients with UC were located mainly in the rectum. Colorectal cancer developed in those with total colitis more frequently than in patients with left-sided colitis or proctitis. The mortality rate of our UC patients was 3.0%. |
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