Koldingsnes W, Nossent H
Department of Rheumatology, University of Tromsø, Norway.
Arthritis Rheum. 2000 Nov;43(11):2481-7. doi: 10.1002/1529-0131(200011)43:11<2481::AID-ANR15>3.0.CO;2-6.
To determine if changes in the incidence, prevalence, and clinical presentation of Wegener's granulomatosis (WG) have occurred in the stable population of northern Norway during a 15-year period.
We performed a retrospective cohort study using hospital discharge records from all 11 hospitals in the region and the databases of the 2 pathology departments in the area. Only patients fulfilling the American College of Rheumatology 1990 criteria for WG were included in the study, and demographic and clinical data at diagnosis were recorded. Incidence, point prevalence, and period prevalence rates were estimated for three 5-year periods.
Fifty-five patients (62% male) with a median age at diagnosis of 50 years (range 10-84 years) fulfilled the inclusion criteria. The annual incidence/ million population increased from 5.2 (95% confidence interval [95% CI] 2.7-9.0) during 1984-1988 to 12.0 (95% CI 8.0-17.3) during 1994-1998. The point prevalence/million increased from 30.4 (95% CI 16.6-51.0) to 95.1 (95% CI 69.1-129.0). The highest incidence rate occurred in men ages 65-74 years. There were no significant period differences in age, first organ involved, delay of diagnosis, or disease activity, but fewer patients had malaise and renal insufficiency during the earliest time period. No seasonal variation in the onset of WG was present, although we noted a pattern of annual fluctuation.
The prevalence of WG has tripled in northern Norway over the last 15 years. While more efficacious therapy may explain part of this increase, we also found a significant trend toward increased incidence over that period. The incidence rate over the last 5 years is the highest reported so far, while the clinical presentation has remained unchanged.
确定在15年期间，挪威北部稳定人群中韦格纳肉芽肿（WG）的发病率、患病率及临床表现是否发生了变化。
我们进行了一项回顾性队列研究，使用该地区所有11家医院的出院记录以及该地区2个病理科的数据库。只有符合美国风湿病学会1990年WG标准的患者纳入研究，并记录诊断时的人口统计学和临床数据。对三个5年时间段的发病率、时点患病率和期间患病率进行了估计。
55例患者（62%为男性）符合纳入标准，诊断时的中位年龄为50岁（范围10 - 84岁）。年发病率/百万人口从1984 - 1988年的5.2（95%置信区间[95%CI]2.7 - 9.0）增至1994 - 1998年的12.0（95%CI 8.0 - 17.3）。时点患病率/百万从30.4（95%CI 16.6 - 51.0）增至95.1（95%CI 69.1 - 129.0）。最高发病率出现在65 - 74岁男性中。在年龄、首发受累器官、诊断延迟或疾病活动方面，各时间段无显著差异，但在最早时间段，出现不适和肾功能不全的患者较少。尽管我们注意到有年度波动模式，但WG发病无季节性变化。
在过去15年中，挪威北部WG的患病率增至三倍。虽然更有效的治疗可能部分解释了这种增加，但我们也发现该期间发病率有显著上升趋势。过去5年的发病率是迄今报告的最高值，而临床表现保持不变。
