Freeman H J
Department of Medicine (Gastroenterology), ACU F-137, University of British Columbia Hospital, 2211 Wesbrook Mall, Vancouver, British Columbia V67 1W5, Canada.
Can J Gastroenterol. 2001 Feb;15(2):89-93. doi: 10.1155/2001/426968.
An international working party at the World Congress of Gastroenterology held in Vienna, Austria from September 6 to 11, 1998 defined a classification for Crohn's disease based on patient age at diagnosis (eg, less than 40 years of age, 40 years of age or older), disease location (eg, terminal ileum, colon, ileocolon or upper gastrointestinal tract) and behaviour (eg, stricturing, penetrating). Disease location in the upper gastrointestinal tract was defined by disease being present proximal to the terminal ileum, regardless of terminal ileal or colon involvement. A 20-year, single clinician database of 877 patients from a university campus hospital was used, and comprised 492 women (56.1%) and 385 men (43.9%). Of these patients, 740 (84.4%) were diagnosed before age 40 years and 137 (15.6%) were diagnosed by 40 years of age or older. Disease was located in the terminal ileum alone in 222 patients (25.3%), colon alone in 238 patients (27.2%) and ileocolon in 304 patients (34.6%). Another 113 patients (13.1%) had disease in the upper gastrointestinal tract, usually with disease also in the terminal ileum (23 patients), colon (12 patients) or ileocolon (71 patients). Only seven of 877 patients had disease located in the upper gastrointestinal tract alone with no distal disease. Disease behaviour could be classified as nonstricturing and nonpenetrating in 256 patients (29.2%), stricturing in 294 patients (33.6%) and penetrating in 327 patients (37.2%). Of the 877 patients with Crohn's disease, 837 were white, 38 were Asian and two were black. In this tertiary care setting of a single clinician practice in a Canadian teaching hospital at the University of British Columbia, Crohn's disease predominantly affects women, and young adults with a high rate of stricturing and penetrating complications.
1998年9月6日至11日在奥地利维也纳举行的世界胃肠病学大会上，一个国际工作小组根据诊断时的患者年龄（如小于40岁、40岁及以上）、疾病部位（如回肠末端、结肠、回结肠或上消化道）和行为（如狭窄、穿透）对克罗恩病进行了分类。上消化道疾病的定义是在回肠末端近端存在疾病，无论回肠末端或结肠是否受累。使用了一个来自大学校园医院的由一名临床医生管理的长达20年的包含877例患者的数据库，其中有492名女性（56.1%）和385名男性（43.9%）。在这些患者中，740例（84.4%）在40岁之前被诊断，137例（15.6%）在年满40岁及以后被诊断。仅回肠末端患病的患者有222例（25.3%），仅结肠患病的患者有238例（27.2%），回结肠患病的患者有304例（34.6%）。另外113例患者（13.1%）上消化道患病，通常同时伴有回肠末端（23例）、结肠（12例）或回结肠（71例）疾病。877例患者中只有7例仅上消化道患病且无远端疾病。疾病行为可分类为非狭窄非穿透型的患者有256例（29. ,2%），狭窄型的有294例（33.6%），穿透型的有327例（37.2%）。在877例克罗恩病患者中，837例为白人，38例为亚洲人，2例为黑人。在英属哥伦比亚大学加拿大教学医院的这一由单一临床医生执业的三级医疗环境中，克罗恩病主要影响女性以及有高比例狭窄和穿透并发症的年轻人。
