Thompson N P, Montgomery S M, Wadsworth M E, Pounder R E, Wakefield A J
Inflammatory Bowel Disease Study Group, Royal Free Hospital School of Medicine, London, UK.
Eur J Gastroenterol Hepatol. 2000 Jan;12(1):25-30. doi: 10.1097/00042737-200012010-00006.
To examine previously cited early risk factors for inflammatory bowel disease.
The 1946 National Survey of Health & Development (NSHD) and the 1958 National Child Development Study (NCDS) are on-going, longitudinal birth cohort studies. A nested case-control design was used combining data from both cohorts; eight controls per case, matched for gender and social class, were selected randomly.
Data concerning maternal infection in pregnancy (NCDS only), childhood infection (measles, mumps and whooping cough), birth order, appendicectomy, breast-feeding and measures of poor housing conditions in childhood were analysed. In both cohorts, the member's hospital physician or medical records were used to confirm the diagnosis.
Twenty-six cases of Crohn's disease and 29 cases of ulcerative colitis were identified. No significant association was found between the development of Crohn's disease or ulcerative colitis and any of the studied factors. There was a trend that those with Crohn's disease were more likely not to have been breast-fed (OR 0.4, 95% CI 0.15-1.03) and not to have had an appendicectomy (OR < 1.00). The opposite was true of those with ulcerative colitis (OR 2.76, 95% CI 0.86-9.81 and OR 2.34, 95% CI 0.69-7.46, respectively). The prevalence of inflammatory bowel disease was 5.12/1000 by the age of 43 years in NSHD and 2.02-2.54/1000 by the age of 33 years in NCDS.
The prevalence of inflammatory bowel disease in these cohorts is among the highest recorded in Europe. Childhood factors may be different for those with Crohn's disease and ulcerative colitis. These cohorts will be increasingly valuable data sources.
研究先前引用的炎症性肠病早期危险因素。
1946年全国健康与发展调查（NSHD）和1958年全国儿童发展研究（NCDS）是正在进行的纵向出生队列研究。采用嵌套病例对照设计，合并两个队列的数据；每个病例随机选取8名对照，按性别和社会阶层匹配。
分析了关于孕期母亲感染（仅NCDS）、儿童期感染（麻疹、腮腺炎和百日咳）、出生顺序、阑尾切除术、母乳喂养以及儿童期住房条件差的相关数据。在两个队列中，均通过成员的医院医生或病历记录来确诊。
共识别出26例克罗恩病和29例溃疡性结肠炎病例。未发现克罗恩病或溃疡性结肠炎的发病与任何研究因素之间存在显著关联。有一个趋势是，克罗恩病患者更有可能未进行母乳喂养（比值比0.4，95%置信区间0.15 - 1.03）且未接受阑尾切除术（比值比<1.00）。溃疡性结肠炎患者情况相反（分别为比值比2.76，95%置信区间0.86 - 9.81和比值比2.34，95%置信区间0.69 - 7.46）。在NSHD中，43岁时炎症性肠病的患病率为5.12/1000，在NCDS中，33岁时为2.02 - 2.54/1000。
这些队列中炎症性肠病的患病率在欧洲有记录以来处于最高水平。克罗恩病和溃疡性结肠炎患者的儿童期因素可能有所不同。这些队列将成为越来越有价值的数据来源。
