Epidemiology of chronic inflammatory bowel disease in the Northern area of Huelva.
Epidemiology of chronic inflammatory bowel disease in the Northern area of Huelva.
复制标题
韦尔瓦北部地区慢性炎症性肠病的流行病学。
DOI：
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发表时间：
2004
影响因子：
2
通讯作者：
F. J. Guerrero
中科院分区：
文献类型：
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作者：
A. Garrido;M. J. Martínez;J. A. Ortega;A. Lobato;M. J. Rodríguez;F. J. Guerrero
目的
了解韦尔瓦省北方地区慢性炎症性肠病（IBD）的不同流行病学方面。
材料和方法
我们对韦尔瓦北方地区77，856名居民中所有诊断为IBD的患者进行了回顾性（1980-1996）和前瞻性（1996-2003）研究。分析克罗恩病（CD）和溃疡性结肠炎（UC）的分布，以及诊断时的性别、年龄和吸烟习惯，家族聚集性，阑尾切除率，表型（解剖部位和临床类型），肠外表现，免疫抑制剂治疗或手术要求。
结果
研究了70例IBD患者，40例UC患者和30例CD患者。性别分布为39例（55.7%）男性（CD组55% vs UC组56.6%; NS）和31例（44.3%）女性（CD组45% vs UC组43.3%; NS）。UC患者的平均就诊年龄为44.7 ± 19.32岁，CD患者为32.3 ± 16.43岁; p < 0.001。家族性关联为7.1%。2.5%的UC患者曾行阑尾切除术，36.7%的CD患者曾行阑尾切除术（p < 0.001），CD患者的吸烟者比例也高于CU患者（66.7% vs 12.5%）（p < 0.001）。UC的解剖部位为：直肠炎20%;直肠乙状结肠炎/左结肠，42.5%;广泛性结肠炎，25%;和全结肠炎，12.5%; CD中：末端回肠，43.3%;结肠，20%;和回结肠，36.7%。病变类型：炎性占56.7%，梗阻占26.7%，瘘管占16.7%。7.5%的UC患者vs 16.6%的CD患者诊断出肠外表现; 1例UC患者vs 10例CD患者进行了手术，1例UC患者vs 12例CD患者需要免疫抑制治疗。多因素分析显示，年龄较小和吸烟习惯是CD与高龄UC的危险因素，在这种情况下，吸烟习惯是保护因素。从1996年开始，IBD的平均发病率（以病例/100，000居民/年表示）为UC 5.2例，CD 6.6例。
结论
我们地区UC的平均发病率为5.2例/100，000/居民/年，CD为6.6例。CD患者的诊断年龄明显小于UC患者;吸烟习惯是CD的风险因素，同时可预防UC。我们地理区域的IBD特征与西班牙其他地区的IBD特征没有实质性差异。
OBJECTIVE
To know the different epidemiologic aspects of chronic inflammatory bowel disease (IBD) in the Northern area of the province of Huelva.
MATERIAL AND METHODS
we carried out a retrospective (1980-1996) and prospective (1996-2003) study of all patients diagnosed with IBD in the Northern area of Huelva, with 77,856 inhabitants. The distribution of Crohn s disease (CD) and ulcerative colitis (UC) was analyzed, as well as sex, age and smoking habit at the time of diagnosis, familial aggregation, appendicectomy rate, phenotype (anatomical site and clinical types), extraintestinal manifestations, and immunosuppressive therapy or surgical requirements.
RESULTS
70 patients with IBD were studied, 40 with UC and 30 with CD. Sex distribution was 39 (55.7%) males (55% with CD vs 56.6% with UC; NS) and 31 (44.3%) females (45% with CD vs 43.3% with UC; NS). Mean age at presentation was 44.7 +/- 19.32 years in UC vs 32.3 +/- 16.43 in CD; p < 0.001. Familial association was 7.1%. Previous appendicectomy was referred in 2.5% of patients with UC vs 36.7% of those with CD (p < 0.001), and the percentage of smokers was also higher in CD 66.7% vs CU 12.5% (p < 0.001). Anatomical site in UC was: proctitis, 20%; proctosigmoiditis/left colon, 42.5%; extensive colitis, 25%; and pancolitis, 12.5%; in CD was: terminal ileum, 43.3%; colon, 20%; and ileo-colon, 36.7%. The disease patterns were: inflammatory 56.7%, obstruction 26.7%, and fistulization 16.7%. Extraintestinal manifestations were diagnosed in 7.5% of patients with UC vs 16.6% patients with CD; surgery was performed in one patient with UC vs 10 with CD, and one patient with UC required immunosuppressive treatment vs 12 with CD. A multivariant analysis showed that younger age and smoking habit were risk factors for CD vs advanced age in UC, in which case, the smoking habit was a protective factor. The mean incidence rate of IBD starting from 1996 and expressed in cases/100,000 inhabitants/year was 5.2 for UC and 6.6 for CD.
CONCLUSIONS
The mean incidence of UC in our area was 5.2 cases/100,000/inhabitants/year, and 6.6 for CD. Patients presenting with CD are diagnosed at a significantly younger age that those with UC; the smoking habit is a risk factor for CD while it protects from UC. The characteristics of IBD in our geographical area do not differ substantially from those in other regions of Spain.