심한 임상경과를 보이는 허혈성 대장염의 위험인자

Abstract

Background: In general, ischemic colitis has a very good prognosis. However, there are a lot of controversies in relation to the prognostic factors. The aim of this study is to evaluate risk factors of severe ischemic colitis. Method: A retrospective study was undertaken of patients with ischemic colitis hospitalized at the Hanyang University Hospital during the interval 2003-2006. Patients were divided into two groups: those with mild course and those with severe course such as needing operation or systemic inflammatory response syndrome or death. Result: A total of 41 cases (M/F = 13/28, mean age=63.8 years) of biopsy proven ischemic colitis were included, of which 31 (75.6%) showed a mild course and 10(24.4%) showed a severe course. Combined medical diseases of patients were hypertension (n=24), diabetes (n=14), end stage renal disease (n=11), cardiovascular disease (n=5) and malignancy (n=5). Male patient (p=0.049), alcoholics (p=0.025), end stage renal disease (p=0.013), LDH (p=0.002), CRP (p=0.014), peritoneal irritation sign (p=0.001), Bun (p=0.006) and Cr (p=0.002) were the significant risk factors of severe ischemic colitis in univariate analysis. In multivariate analysis, end stage renal disease (p=0.026) was the only significant risk factor of severe ischemic colitis. Conclusions: Careful attention must be paid to end stage renal disease patients having ischemic colitis.