RÉSUMÉ
Objective:To analyze the trend of medication use in patients with ulcerative colitis (UC) in recent ten years in at Xijing Hospital, Air Force Military Medical University.Methods:From 2010 to 2019, the clinical data of 1 425 patients diagnosed with UC in the Department of Gastroenterology at Xijing Hospital, Air Force Medical University, were retrospectively collected. According to the period of medication, the UC patients were divided into year 2010 to 2014 group and year 2015 to 2019 group. The general information and the medication trend of year 2010 to 2014 group and year 2015 to 2019 group were analyzed. And then according to gender and age (<40 years old and ≥40 years old), patients were divided into subgroups and analyzed. Independent sample t test and chi-square test were used for statistical analysis. Results:The number of UC patients of year 2010 to 2014 group and year 2015 to 2019 group was 369 and 1 056, respectively. The percentages of patients in remission of the two groups were 9.5% (35/369) and 12.0% (127/1 056), respectively; the percentages of mild patients were 40.4% (149/369) and 41.6% (439/1 056), respectively; the percentages of moderate patients were 37.4% (138/369) and 28.9% (305/1 056), respectively; the percentages of severe patients were 12.7% (47/369) and 17.5% (185/1 056), respectively. There was no significant difference in the proportion of UC patients with different degrees between year 2010 to 2014 group and year 2015 to 2019 group ( P>0.05). There were no significant differences in the age and proportion of female between the year 2010 to 2014 group and year 2015 to 2019 group ((46.2±15.3) years old vs. (44.6±30.6) years old; 45.8%, 169/369 vs. 44.8%, 473/1 056; both P>0.05). The utilization rates of 5-aminosalicylic acid (5-ASA), glucocorticoid, immunosuppressants, and biological agents of the year 2015 to 2019 group were all higher than those of the year 2010 to 2014 group (96.8%, 1 022/1 056 vs. 90.0%, 332/369; 29.9%, 316/1 056 vs. 14.6%, 54/369; 8.4%, 89/1 056 vs. 2.4%, 9/369; 4.8%, 51/1 056 vs. 0.5%, 2/369, respectively), and the differences were all statistically significant ( χ2=26.766, 33.256, 15.315 and 14.038, all P<0.01). Within each of the year 2010 to 2014 group and the year 2015 to 2019 group, there were no significant differences between the female and male in the age, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents ((47.2±13.6) years old vs. (45.3±16.5) years old, (43.1±12.9) years old vs. (45.8±39.5) years old, 88.8%, 150/169 vs. 91.0%, 182/200; 96.8%, 458/473 vs. 96.7%, 564/583; 13.6%, 23/169 vs. 15.5%, 31/200; 28.3%, 134/473 vs. 31.2%, 182/583; 2.4%, 4/169 vs. 2.5%, 5/200; 7.0%, 33/473 vs. 9.6%, 56/583; 0 vs. 1.0%, 2/200; 5.3%, 25/473 vs. 4.5%, 26/583; all P>0.05). In the patients aged≥40 years old of the year 2010 to 2014 group, the proportion of females was higher than that of the patients aged <40 years old (50.2%, 121/241 vs. 37.5%, 48/128), and the utilization rate of 5-ASA in patients aged ≥40 years old was lower than that of patients aged <40 years old (85.9%, 207/241 vs. 97.7%, 125/128), and the differences were statistically significant ( χ2=5.438 and 12.824, P=0.020 and P<0.01). In the year 2010 to 2014 group, there were no statistically significant differences in the utilization rates of glucocorticoid, immunosuppressants and biological agents between patients aged ≥40 years old and patients aged <40 years old (13.7%, 33/241 vs. 16.4%, 21/128; 2.1%, 5/241 vs. 3.1%, 4/128; 0 vs. 1.6%, 2/128; all P>0.05). In the year 2015 to 2019 group, the utilization rate of biological agents in patients aged≥40 years old was lower than that in patients aged<40 years old (3.7%, 23/630 vs. 46.5%, 198/426), and the difference was statistically significant ( χ2=4.721, P=0.030). In the year 2015 to 2019 group, there were no statistically significant differences in female proportion, utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents between patients aged≥40 years old and patients aged <40 years old (43.7%, 275/630 vs. 46.5%, 198/426; 96.0%, 605/630 vs. 97.9%, 417/426; 29.7%, 187/630 vs. 30.3%, 129/426; 8.6%, 54/630 vs. 8.2%, 35/426; all P>0.05). Conclusions:Compared with year 2010 to 2014, the number of UC patients remarkably increased in the year 2015 to 2019 in the Department of Gastroenterology, Xijing Hospiatal, Air Force Medical University. The utilization rates of 5-ASA, glucocorticoid, immunosuppressants and biological agents all increased in UC patients. The medication trends of UC patients with different gender were almost the same. The medication trends of UC patients with different age were different.
RÉSUMÉ
Background: Inflammatory bowel disease (IBD) is a recurrent disease with unknown etiology. Psychological disorders such as anxiety, depression and fear are commonly seen in IBD patients and seriously reduce the quality of life. Aims: To investigate the current status of fear of progression in patients with IBD and its relationship with the quality of life. Methods: IBD patients admitted to the Department of Gastroenterology, Xijing Hospital, Air Force Medical University from October 2020 to December 2020 were enrolled consecutively. The demographic data and clinical data on disease course and severity were collected. A questionnaire survey was conducted by using Fear of Progression Questionnaire-Short Form (FoP-Q-SF) and the MOS 36-Item Short-Form Health Survey (SF-36). Results: A total of 225 IBD patients were enrolled, including 146 cases of ulcerative colitis (UC) and 79 cases of Crohn's disease (CD). The mean score of FoP-Q-SF was 34.89±9.70. Using 34 points as the cut-off value, 53.3% of the IBD patients were identified as fear of progression. The FoP-Q-SF score in CD patients was significantly higher than that in UC patients (36.92±10.47 vs. 33.80±9.11, P<0.05). Fear of progression was positively correlated with the disease activity and severity in both UC and CD patients (all P<0.05), whereas age was negatively correlated with fear of progression (P<0.05). In patients with FoP-Q-SF score equal or greater than 34 points, scores of 5 health concepts of SF-36 scale, including physical functioning, role-physical, role-emotional, mental health, and general health were significantly lower than those with FoP-Q-SF score less than 34 points (all P<0.05). In addition, the quality of life was also affected by age, education level and length of disease course. Conclusions: Fear of progression is prevalent in IBD patients and may affect the quality of life, and is correlated with disease type (UC/CD), age and activity and severity of the disease.
RÉSUMÉ
Objective:To analyze the difference of psychosocial characteristics in patients with chronic gastritis.Methods:From June to December 2018, a total of 300 patients with chronic gastritis visited Xijing Hospital were consecutively enrolled. The patients were divided into chronic non-atrophic gastritis (CNAG) group, chronic atrophic gastritis (CAG) group and CAG with intestinal metaplasia group, with 100 cases in each group. Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), living events scale (LES) and Eysenck personality questionnaire (EPQ) were used for evaluation and analysis. Chi square test, analysis of variance, nonparametric rank sum test and Kruskal Wallis H test were used for statistical analysis. Results:The incidences of anxiety of the CAG group and the CAG with intestinal metaplasia group were both significantly higher than that of the CNAG group (64.0%, 64/100; 53.0%, 53/100; and 34.0%, 34/100; respectively), and the differences were statistically significant ( χ2=0.007 and 0.001, both P<0.05). The incidence of depression of the CAG with intestinal metaplasia group was significantly higher than those of CNAG group and the CAG group (24.0%, 24/100; 15.0%, 15/100 and 13.0%, 13/100; respectively), and the differences were statistically significant ( χ2=0.108 and 0.045, both P<0.05). The negative event score of LES of CAG with intestinal metaplasia group was higher than those of CNAG group and CAG group (0 (0, 6.75), 0 (0, 1.00), 0 (0, 0.75) respectively), and the differences were statistically significant ( Z=-2.619 and -3.022, both P<0.05). The proportion of patients with LES score ≥20 points (high mental stress) of CNAG group, CAG group and CAG with intestinal metaplasia group gradually increased (8.0%, 8/100; 9.0%, 9/100 and 18.0%, 18/100; respectively), and the difference was statistically significant ( χ2=0.036, P<0.05). In male patients and patients under 50 years old, the incidence of depression and the proportions of patients with LES score ≥20 points of CAG with intestinal metaplasia group were higher than those of CNAG group (22.5%, 9/40 vs. 9.6%, 5/52; 47.5%, 19/40 vs. 16.2%, 11/68; 22.5%, 9/40 vs. 7.7%, 4/52; and 20.0%, 8/40 vs. 4.4%, 3/68), and the differences were statistically significant ( χ2=0.015, 0.001, 0.043 and 0.013, all P<0.05). The results of EPQ showed that the psychoticism, extraversion or introversion, stability and concealment of CNAG group and CAG with intestinal metaplasia group, were mostly normal (43.3 to 56.7), accounting for 62.0% (62/100) and 45.0% (45/100), 56.0% (56/100) and 44.0% (44/100), 54.0% (54/100) and 44.0% (44/100), 59.0% (59/100) and 45.0% (45/100), respectively. The percentage of patients with high score (>56.7) of etraversion or introversion and concealment in CAG group and the CAG with intestinal metaplasia group were higher than those in the CNAG group (48.0%, 48/100; 23.0%, 23/100; 4.0%, 4/100 and 46.0%, 46/100; 21.0%, 21/100 and 7.0%, 7/100, respectively), and the differences were statistically significant ( χ2=0.001, 0.001, 0.001 and 0.004, all P<0.01). Conclusions:Anxiety is associated with CAG and intestinal metaplasia, while depression is associated with intestinal metaplasia. In male patients and patients under 50 years old, depression, negative event and high psychiatric stress are more significantly related to intestinal metaplasia. The mental characteristics of extroversion, emotional instability, psychoticism and concealment are closely associated with CAG.