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A total of 44 patients with long-standing ulcerative colitis were studied to elucidate changes over time in colonoscopic and histological inflammatory activity. More than two years of symptomatic remission without melena or bloody diarrhea was achieved in 63.6% (28/44). All patients underwent total colonoscopic examinations. Compared with findings of the previously involved area, 70.5% (31/44) showed a reduction or disappearance of the inflammatory area on endoscopic and histological examinations; however, the rectal inflammation disappeared in 31.8% (14/44) of patients. Moreover, it became apparent that the remaining active inflammatory area tended to show discontinuous spread with patchy inflammatory foci. Thus, the mucosal inflammation in long-standing ulcerative colitis may be characterized by a reduction in both extent and degree.

潰瘍性大腸炎の病変局所における液性免疫の病態をみる目的で,免疫グロブリン陽性細胞(IgA,IgG,IgM)について検討した.潰瘍性大腸炎27例の直腸粘膜より内視鏡下に採取した生検組織45病変,および活動期の症例で明らかに炎症部より離れた正常外観粘膜部よりの生検組織6試料を対象とし,酵素抗体直接法を用いて陽性細胞を同定した.その結果,いずれの陽性細胞も,潰瘍性大腸炎の活動期に,緩解期およびコントロール群に比べ,有意に増加した.特に,IgGおよびIgM陽性細胞は,コントロール群に比べ,おのおの4.3倍および4.5倍と著明に増加した,IgGおよびIgM陽性細胞は,活動期より緩解期になると,有意に減少した.炎症部より離れた正常外観粘膜部では,IgA陽性細胞の減少傾向,IgG陽性細胞の増加傾向が認められた.以上より,潰瘍性大腸炎の炎症粘膜のみならず,正常外観粘膜部でも液性免疫系の異常が示唆された.