ANALYSIS OF CLINICAL COURSE OF POSTOPERATIVE RECURRENCE IN CROHNS-DISEASE OF DISTAL ILEUM
ANALYSIS OF CLINICAL COURSE OF POSTOPERATIVE RECURRENCE IN CROHNS-DISEASE OF DISTAL ILEUM
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DOI：
10.1007/bf01308174
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发表时间：
1992-02-01
影响因子：
3.1
通讯作者：
TORSOLI, A
中科院分区：
文献类型：
--
作者：
PALLONE, F;BOIRIVANT, M;TORSOLI, A
在本研究中，我们调查了克罗恩病患者从最初的疾病到术后复发的临床病程是否保持不变。对 58 名发生术后复发的切除患者进行了 4.2 +/- 3 年（中位 3 年）的随访。初发疾病的每年发作频率为 1.9 +/- 1.0（中位数 1.5），复发性疾病的每年发作频率为 1.7 +/- 1.0（中位数 1.7）。在初发疾病期间出现并发症的患者中，复发性疾病过程中出现并发症的频率显着高于其他患者（27/42 vs 3/16，P = 0.002）。在初次发病时出现这些并发症的患者中，复发性疾病中梗阻和肠外表现的频率高于未出现这些并发症的患者（19/29 vs 6/29，P = 0.0006，4/5 vs 4/53，P = 0.0008）。初次发病期间出现并发症的患者在复发性疾病过程中出现并发症的累积概率较高（P < 0.001）。生存分析显示，初次发病时出现梗阻和肠外并发症的患者复发时发生梗阻和肠外并发症的累积概率较高（P < 0.005）。这些数据表明，回肠远端克罗恩病的临床病程从初始疾病到术后复发疾病保持相同。这项研究还表明，可以合理预测复发性疾病的短期病程。
In the present study we have investigated whether in patients with Crohn's Disease the clinical course remains the same from the initial disease to postoperative recurrent disease. Fifty-eight resected patients who developed a postoperative recurrence were followed for 4.2 +/- 3 years (median 3 years). The yearly frequency of flare-up was 1.9 +/- 1.0 (median 1.5) in the initial disease and 1.7 +/- 1.0 (median 1.7) in recurrent disease. In patients who experienced complications during the initial disease, the frequency of complications during the course of recurrent disease was significantly higher than in the others (27/42 vs 3/16, P = 0.002). The frequency of obstruction and extraintestinal manifestations in the recurrent disease was higher in patients who suffered these complications in the initial disease than in those who did not (19/29 vs 6/29, P = 0.0006, and 4/5 vs 4/53, P = 0.0008). The cumulative probability of complication during the course of recurrent disease was higher in patients with complications during the initial disease (P < 0.001). The survival analysis showed that the cumulative probability of obstruction and extraintestinal complication in recurrent disease was higher in patients who suffered these complications in the initial disease (P < 0.005). These data indicate that the clinical course of Crohn's disease of the distal ileum remains the same from the initial disease to postoperative recurrent disease. This study also suggests that the short-term course of recurrent disease can reasonably be predicted.