Heikenen J B, Werlin S L, Brown C W, Balint J P
Department of Pediatrics, Medical College of Wisconsin, Milwaukee 53226, USA.
Inflamm Bowel Dis. 1999 Aug;5(3):158-60. doi: 10.1097/00054725-199908000-00002.
Presenting symptoms and their duration may affect the time that elapses prior to definitive diagnosis of inflammatory bowel disease (IBD). This study was undertaken to determine the mean duration of presenting symptoms and diagnostic lag in children with IBD. The medical records of all patients less than 19 years of age diagnosed with IBD at the pediatric gastroenterology clinic of Children's Hospital of Wisconsin between 1990-1995 were reviewed. The age at diagnosis, gender, presenting symptoms and duration, disease location, and diagnostic lag were analyzed. There were 91 children (49 male) diagnosed with IBD. Crohn's disease (CD) was diagnosed in 58, ulcerative colitis (UC) in 24, and indeterminate colitis in 9. The mean ages at diagnosis were 11.4 years for CD, 9.7 years for UC, and 7.8 years for indeterminate colitis. The most frequent presenting symptoms were abdominal pain, diarrhea, hematochezia, and weight loss. The average lag in diagnosis of CD was 7.1 months, which varied by disease location: small intestine 10.5 months, ileocolonic 7.5 months, and colonic 6.4 months. The average lag in diagnosis was 6.7 months for UC and 14 months for indeterminate colitis. Children presenting with growth failure had the longest diagnostic lag. (a) The elapsed time between symptom onset and the diagnosis of CD has decreased. (b) The diagnostic lag in CD decreases with distal colonic involvement. (c) Following onset of symptoms UC was diagnosed only slightly more rapidly than CD.
出现的症状及其持续时间可能会影响炎症性肠病（IBD）确诊前的时间。本研究旨在确定IBD患儿出现症状的平均持续时间和诊断延迟。回顾了1990年至1995年间在威斯康星儿童医院儿科胃肠病诊所确诊为IBD的所有19岁以下患者的病历。分析了诊断时的年龄、性别、出现的症状及持续时间、疾病部位和诊断延迟。有91名儿童（49名男性）被诊断为IBD。其中58例诊断为克罗恩病（CD），24例为溃疡性结肠炎（UC），9例为不确定性结肠炎。CD诊断时的平均年龄为11.4岁，UC为9.7岁，不确定性结肠炎为7.8岁。最常见的出现症状为腹痛、腹泻、便血和体重减轻。CD诊断的平均延迟为7.1个月，因疾病部位而异：小肠为10.5个月，回结肠为7.5个月，结肠为6.4个月。UC诊断的平均延迟为6.7个月，不确定性结肠炎为14个月。出现生长发育迟缓的儿童诊断延迟最长。（a）从症状出现到CD诊断的时间间隔有所缩短。（b）CD的诊断延迟随结肠远端受累而缩短。（c）症状出现后，UC的诊断仅比CD稍快一点。
