Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan City, Central China
Retrospective survey of 452 patients with inflammatory bowel disease in Wuhan City, Central China
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DOI：
10.1097/01.mib.0000201098.26450.ae
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发表时间：
2006-03-01
影响因子：
4.9
通讯作者：
Xu, H
中科院分区：
文献类型：
--
作者：
Jiang, L;Xia, B;Xu, H
背景：直到1990年左右，炎症性肠病（IBD）在中国并不常见，但从那时起，它越来越多地出现在临床上。中国人群 IBD 的患病率和表型尚不清楚。本研究调查了中国中部武汉市溃疡性结肠炎（UC）和克罗恩病（CD）的患病趋势，并评估了近14年来IBD的临床特征、肠外表现和治疗情况。方法：回顾性收集武汉市5家中心医院自1990年以来获得高质量内镜和组织学诊断的389例UC患者和63例CD患者。至2003年，根据国际公认的Lennard-Jones标准，根据临床、实验、放射学、内镜和组织学检查诊断UC和CD。结果：1990年至2003年间，武汉市UC和CD的患病率呈上升趋势。 1990年至1996年与1997年至2003年相比，UC和CD的性别和年龄分布没有变化。然而，1997年至2003年UC患者中受过高等教育和从事专业职业的人数明显高于1990年至1996年期间的UC患者（OR 2.1，95% CI 1.27-3.35，P = 0.004；OR 2.2，95% CI 1.31-3.61，P = 0.003）。诊断时 CD 患者的平均年龄明显低于 UC 患者（32.6 +/- 12.5 vs. 42 +/- 14.5，P < 0.0001）。 UC患者的男女比例为1.53:1，CD患者的男女比例为2.32:1。 UC 中从发病到诊断的平均时间为 1.4 年，CD 中为 1.1 年。 UC和CD的肠外表现分别为5.7%和19%，UC和CD的并发症分别为6.4%和50.8%。只有3%的UC患者需要手术治疗，而27%的CD患者接受了手术治疗（P < 0.001）。结论：中国中部武汉市IBD患病率有所上升，但并不像西方国家那么高。武汉市的这种疾病往往与受过高等教育的年轻职业男性有关。 UC 的临床表现通常较轻，很少有肠道外表现。
Background: Inflammatory bowel disease (IBD) had been uncommon in China until about 1990, but since then, it has been seen in the clinical setting more and more. The prevalence and phenotype of IBD in the Chinese population is not well known. The present study investigates the trend of prevalence in ulcerative colitis (UC) and Crohn's disease (CD) in Wuhan City, central China, and evaluates clinical features, extraintestinal manifestations, and the treatment of IBD in the last 14 years.Methods: Three hundred and eighty-nine patients with UC and 63 patients with CD were retrospectively collected from 5 central hospitals in Wuhan City, in which high-quality endoscopic and histological diagnoses were available from 1990 to 2003. UC and CD were diagnosed based on clinical, experimental, radiological, endoscopic, and histological examinations according to the internationally accepted Lennard-Jones criteria.Results: The trend toward prevalence of UC and CD increased between 1990 and 2003 in Wuhan City. There was no change in the sex and age distribution comparing 1990 to 1996 with 1997 to 2003 both in UC and CD. However, the number of individuals with higher education and a professional occupation during 1997 to 2003 was significantly higher than that during the period 1990 to 1996 in patients with UC (OR 2.1, 95% CI 1.27-3.35, P = 0.004; OR 2.2, 95% CI 1.31-3.61, P = 0.003). The mean age of patients with CD was significantly younger than that of UC at the time of diagnosis (32.6 +/- 12.5 vs. 42 +/- 14.5, P < 0.0001). The ratio of male to female patients was 1.53:1 in UC and 2.32:1 in CD, respectively. The mean duration of onset of the disease to diagnosis was 1.4 years in UC and 1.1 years in CD. The extra intestinal manifestations of UC and CD were 5.7% and 19%, respectively, and complications of UC and CD were 6.4% and 50.8%, respectively. Only 3% of UC patients required surgery, whereas 27% of CD patients underwent surgical procedures (P < 0.001).Conclusion: The prevalence of IBD has increased in Wuhan City, central China, but is not as high as in Western countries. The disease in Wuhan City has often been associated with young adult professional males with a high level of education. The clinical presentation of UC was often mild and had few extra intestinal manifestations.