Touze I, Gower-Rousseau C, Grandbastien B, Paris J C, Quandalle P, Cortot A, Colombel J F
Service de Chirurgie Adultes Ouest, Hôpital Huriez, CHU, Lille.
Gastroenterol Clin Biol. 1999 Mar;23(3):307-11.
Diffuse jejuno-ileitis of Crohn's disease may be a homogeneous clinical subgroup. The aim of this work was to compare the demographic and clinical data at diagnosis and the initial treatments of patients with diffuse jejuno-ileitis of Crohn's disease and to the ones without this localization.
For demographic and clinical studies, 48 (32M/16F) incident cases of diffuse jejuno-ileitis of Crohn's disease diagnosed between 1988 and 1994 in the EPIMAD register were compared with 96 (48M/48F) controls diagnosed the same year. As far as for the therapeutic management, the 48 incident cases were compared with 48 controls.
Diffuse jejuno-ileitis constituted 3.3% of the total incident cases. Median age at diagnosis was significantly lower (20 vs 23 years, P = 0.01) and an upper digestive involvement was more frequent (56% vs 34%, P = 0.03) in patients with diffuse jejuno-ileitis. These patients were more often treated by total parenteral nutrition (43.8% vs 19.6%, P = 0.01) or azathioprine (50% vs 20.8%, P = 0.005). Azathioprine was also introduced earlier (20.7 vs 40.3 months, P = 0.009). Surgery for resection was less often required in diffuse jejuno-ileitis than in controls (65.2% vs 99.8%, P = 0.02) while more stricturoplasties were performed (52.9% vs 10%, P = 0.003); overall surgical rates did not significantly differ in the 2 groups.
Our series suggest that diffuse jejuno-ileitis of Crohn's disease is a subgroup of patients characterized by a young age at diagnosis, with more frequent and earlier requirement for azathioprine.
克罗恩病的弥漫性空肠回肠炎可能是一个同质的临床亚组。本研究的目的是比较克罗恩病弥漫性空肠回肠炎患者与非该部位病变患者在诊断时的人口统计学和临床数据以及初始治疗情况。
在人口统计学和临床研究中，将1988年至1994年在EPIMAD登记册中诊断出的48例（32例男性/16例女性）克罗恩病弥漫性空肠回肠炎的新发病例与同年诊断出的96例（48例男性/48例女性）对照进行比较。在治疗管理方面，将48例新发病例与48例对照进行比较。
弥漫性空肠回肠炎占总新发病例的3.3%。弥漫性空肠回肠炎患者诊断时的中位年龄显著更低（20岁对23岁，P = 0.01），上消化道受累更常见（56%对34%，P = 0.03）。这些患者更常接受全肠外营养治疗（43.8%对19.6%，P = 0.01）或硫唑嘌呤治疗（50%对20.8%，P = 0.005）。硫唑嘌呤的使用也更早（20.7个月对40.3个月，P = 0.009）。与对照组相比，弥漫性空肠回肠炎患者较少需要进行切除手术（65.2%对99.8%，P = 0.02），而更多地进行了狭窄成形术（52.9%对10%，P = 0.003）；两组的总体手术率无显著差异。
我们的系列研究表明，克罗恩病的弥漫性空肠回肠炎是一组以诊断时年龄较轻、更频繁且更早需要使用硫唑嘌呤为特征的患者亚组。
