Analysis of clinical characteristics and treatment effect of perianal Crohn′s disease with or without proctitis

Abstract

Objective To investigate the clinical characteristics of perianal Crohn′s disease (CD) with or without proctitis and compare the treatment effect of surgery combined with biological preparation. Methods The retrospective cohort study was conducted. The clinical data of 52 patients with perianal CD who were admitted to the Affiliated Hospital of Nanjing University of Traditional Chinese Medicine from June 2011 to October 2014 were collected. Thirty patients with inflammation involvement of the rectum and 22 patients without inflammation involvement of the rectum were respectively divided into the proctitis group and non-proctitis group. All the 52 patients underwent surgery combined with infliximab therapy. Observation indicators included: (1) clinical characteristics: gender, age, body mass index (BMI), lesion location, disease behavior, type of perianal lesions, history of perianal surgeries, CD activity index (CDAI), perianal disease activity index (PDAI), C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), white blood cell (WBC), platelet (PLT) and albumin (Alb), (2) treatment and follow-up. Follow-up using outpatient examination was performed to evaluate the perianal lesions up to December 2015. Measurement data with normal distribution were described as ±s and comparison between groups was analyzed by the t test. Count data were described as the percentage, and comparison between groups was analyzed by the chi-square test and Fisher′s exact probability. Results (1) Clinical characteristics: number of patients with BMI normal level and =normal level, Alb 0.05). The total healed rate, improvement rate and unhealed rate of perianal lesion were 55.8%(29/52), 34.6%(18/52) and 9.6%(5/52), respectively. The number of patients with healed, improved and unhealed perianal lesions were 16, 11, 3 in the proctitis group and 13, 7, 2 in the non-proctitis group, respectively, showing no significant difference in treatment effects between the 2 groups (χ2=0.173, P>0.05). Conclusions Patients with perianal CD combined with proctitis have higher activity of intestinal inflammation and worse nutritional status compared with patients without proctitis. However, there is no significant difference in the type and activity of perianal lesion between patients with or without proctitis. Surgery combined with biological preparation could render better clinical outcomes in treatment of perianal CD with proctitis. Key words: Crohn′s disease; Anus disease; Proctitis; Clinical characteristics; Therapy