Fernández-Bañares F, Salas A, Forné M, Esteve M, Espinós J, Viver J M
Department of Gastroenterology, Hospital Universitari Mútua de Terrassa, Barcelona, Catalonia, Spain.
Am J Gastroenterol. 1999 Feb;94(2):418-23. doi: 10.1111/j.1572-0241.1999.00870.x.
The incidence of collagenous and lymphocytic colitis is not well known. We sought to assess the incidence of collagenous and lymphocytic colitis in a well-defined population during a 5-yr study period.
From January 1, 1993, to December 31, 1997, all new patients diagnosed with collagenous or lymphocytic colitis living in the catchment area of the Hospital Mutua de Terrassa (Barcelona, Spain) were identified. Since 1993 all patients with chronic diarrhea were referred for a diagnostic colonoscopy. Multiple biopsy sampling of the entire colon was performed when appearance of the colonic mucosa was grossly normal.
Twenty-three cases of collagenous colitis and 37 of lymphocytic colitis were diagnosed. The female:male ratios were 4.75:1 and 2.7:1 for collagenous and lymphocytic colitis, respectively. The mean age at onset of symptoms was 53.4+/-3.2 (range, 29-82) yr for collagenous colitis, and 64.3+/-2.7 (range, 28-87) yr for lymphocytic colitis (p = 0.012). The mean annual incidence per 100,000 inhabitants based on the year of onset of symptoms was 1.1 (95% confidence interval [CI], 0.4-1.7) for collagenous colitis, and 3.1 (95% CI, 2.0-4.2) for lymphocytic colitis. A peak incidence was observed in older women in both diseases. A rate of microscopic colitis of 9.5 per 100 normal-looking colonoscopies performed in patients with chronic watery diarrhea was observed. Normal rectal biopsies were found in 43 % and 8% of patients with collagenous and lymphocytic colitis, respectively.
The incidence of lymphocytic colitis is three times higher than that of collagenous colitis. Microscopic colitis should be considered as a major possibility in the work-up of chronic diarrhea in older women.
胶原性结肠炎和淋巴细胞性结肠炎的发病率尚不明确。我们试图在一项为期5年的研究期间评估在一个明确界定的人群中胶原性结肠炎和淋巴细胞性结肠炎的发病率。
从1993年1月1日至1997年12月31日，确定了居住在西班牙巴塞罗那特拉萨斯互助医院服务区域内所有新诊断为胶原性或淋巴细胞性结肠炎的患者。自1993年以来，所有慢性腹泻患者均被转诊进行诊断性结肠镜检查。当结肠黏膜外观大体正常时，对整个结肠进行多次活检取样。
诊断出23例胶原性结肠炎和37例淋巴细胞性结肠炎。胶原性结肠炎和淋巴细胞性结肠炎的女性与男性比例分别为4.75:1和2.7:1。胶原性结肠炎症状出现时的平均年龄为53.4±3.2（范围29 - 82）岁，淋巴细胞性结肠炎为64.3±2.7（范围28 - 87）岁（p = 0.012）。基于症状出现年份，每10万居民中胶原性结肠炎的年平均发病率为1.1（95%置信区间[CI]，0.4 - 1.7），淋巴细胞性结肠炎为3.1（95% CI，2.0 - 4.2）。两种疾病在老年女性中均观察到发病率高峰。在慢性水样腹泻患者中，每100例外观正常的结肠镜检查中显微镜下结肠炎的发生率为9.5。分别在43%和8%的胶原性和淋巴细胞性结肠炎患者中发现直肠活检正常。
淋巴细胞性结肠炎的发病率比胶原性结肠炎高3倍。在对老年女性慢性腹泻进行检查时，应将显微镜下结肠炎视为主要的可能病因。
