Changes over a 20-year period in the clinical presentation of primary sclerosing cholangitis in Sweden
Changes over a 20-year period in the clinical presentation of primary sclerosing cholangitis in Sweden
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DOI：
10.1080/00365520600787994
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发表时间：
2007-01-01
影响因子：
1.9
通讯作者：
Broome, Ulrika
中科院分区：
文献类型：
--
作者：
Bergquist, Annika;Said, Karouk;Broome, Ulrika
Objective.磁共振胰胆管成像（MRCP）作为原发性硬化性胆管炎（PSC）的非侵入性诊断工具，加上临床对该病认识的提高，已导致早期诊断。本研究的目的是调查PSC的临床表现，包括其与炎症性肠病（IBD）和胆管癌的发展在一个中心超过20年的观察期。材料和方法。所有明确定义的PSC患者，在16岁后诊断，并在1984年至2004年期间在Huddinge大学医院接受治疗，均纳入本研究（n = 246）。PSC和IBD特征从患者的病历中检索。根据诊断日期对患者进行了细分：1998年10月30日之前诊断的185例PSC患者与该日期之后诊断的61例患者进行了比较。结果1998年以后诊断的患者在诊断时年龄明显较大（平均年龄41岁对37岁），症状较少（47%对63%），同时并存IBD的频率较低（69%对82%）。在整个组中，女性的症状明显多于男性，尤其是瘙痒（p < 0.05）。结论.在过去的20年里，瑞典PSC的临床谱发生了变化;今天，PSC患者在诊断时年龄较大，相关IBD不太常见。
Objective. The use of magnetic resonance cholangiopancreaticography (MRCP) as a non-invasive diagnostic tool for primary sclerosing cholangitis (PSC), together with increased clinical awareness of the disease, has led to earlier diagnosis. The aim of this study was to investigate the clinical presentation of PSC including its association with inflammatory bowel disease (IBD) and the development of cholangiocarcinoma at one centre over an observation period of 20 years. Material and methods. All patients with well-defined PSC, diagnosed after 16 years of age and treated at Huddinge University Hospital between 1984 and 2004, were included in the study (n = 246). PSC and IBD characteristics were retrieved from the patients' medical records. The patients were subdivided according to the date of diagnosis: 185 PSC patients diagnosed before 30 October 1998 were compared with 61 patients diagnosed after that date. Results. Patients diagnosed after 1998 were significantly older at diagnosis (mean age 41 versus 37 years) and presented fewer symptoms (47% versus 63%) as well as a lower frequency of coexisting IBD (69% versus 82%). In the whole group, women had significantly more symptoms than men, particularly pruritus (p < 0.05). Conclusions. The clinical spectrum of PSC in Sweden has changed over the past 20 years; today, PSC patients are older at diagnosis and associated IBD is less frequent.