Saro Gismera C, Riestra Menéndez S, Sánchez Fernández R, Milla Crespo A, Lacort Fernández M, Argüelles Fernández G, Chobak Z, Florido Mancheño J I, Antón Magarzo J L, Altadill Arregui A, Vizoso F, Pineda García E, Fernández de Ocariz Archs E, Albert Colomer J, García Pérez J, López Rivas L, Lombraña J L S
Hospital de Cabueñes. Asturias, Spain.
An Med Interna. 2003 May;20(5):232-8.
The epidemiologic analysis inflammatory bowel disease (IBD) is a powerful research tool to assess the contribution of environmental factors to its etiology. IBD has been reported to have varying frequencies in different parts of the world, and there seem to be significant differences in the disease pattern and clinical course. The aim of the present study was to assess the disease pattern of IBD in Asturias (Spain).
A descriptive epidemiological population based study, retrospective (1954-1993) and prospective (1994-97), was performed to study 1018 patients found, bigger than 14 years, to have IBD, in five areas of Asturias (Spain) (461.965 inhabitants).
During the period of time studied, we diagnosed 1018 IBD [565 ulcerative colitis (55.5%), 415 (40.8%) Crohn's disease and 38(3.7%) indeterminate colitis], with 482 females (47.2%), 536 males (52.8%), and male/female: 1.11. Age at diagnosis were 39.49 +/- 1.08 (95% CI : 38.41 +/- 40.57); (UC: 43.95 +/- 1.47; CD: 33.53 +/- 1.51; IC: 38.26 +/- 5.14. p = 0.000. Age at onset previously at diagnosis for UC: 42.84 +/- 1.34; CD: 30.68 +/- 1.40; IC: 36.74 +/- 4.86 (p = 0.000). Diagnosis criteria: UC: syntomatic 97.34% (p = ns), endoscopy 96.63% (p = 0.000 pathology 90.26% (p = 0.000). CD: radiology 83.61% (p =0.000). Study level in CD: 57.57 (p = 0.0005). Family history: 8.4%. The most frequent involvement at diagnosis of UC was proctitis only, in 13.6%, 269% rectum and sigmoid 26% let colitis, 20% pancolitis, and in CD colon only, in 16.7%, 30.3% terminal ileum, 41.3% ileo-colon of the patients. This also helps to explain the differences in severity, need for surgery, and survival noted between community based studies.
We highlight the uniformity of distribution of the inflammatory bowel disease in relation to types and sex. The high frequency of familial Crohn's disease suggests a genetic predisposition. Highlighting a bigger morbilidad for the Crohn's Disease reflected in the surgical requirements, but however with smaller mortality that in ulcerative colitis.
炎症性肠病（IBD）的流行病学分析是评估环境因素对其病因学贡献的有力研究工具。据报道，IBD在世界不同地区的发病率各不相同，疾病模式和临床病程似乎也存在显著差异。本研究的目的是评估西班牙阿斯图里亚斯地区IBD的疾病模式。
进行了一项基于人群的描述性流行病学研究，回顾性研究（1954 - 1993年）和前瞻性研究（1994 - 1997年），以研究在西班牙阿斯图里亚斯五个地区（461965名居民）发现的1018例年龄大于14岁的IBD患者。
在研究期间，我们诊断出1018例IBD [565例溃疡性结肠炎（55.5%），415例（40.8%）克罗恩病和38例（3.7%）未定型结肠炎]，其中女性482例（47.2%），男性536例（52.8%），男女比例为1.11。诊断时的年龄为39.49±1.08（95%可信区间：38.41±40.57）；（溃疡性结肠炎：43.95±1.47；克罗恩病：33.53±1.51；未定型结肠炎：38.26±5.14。p = 0.000。诊断前发病年龄：溃疡性结肠炎：42.84±1.34；克罗恩病：30.68±1.40；未定型结肠炎：36.74±4.86（p = 0.000）。诊断标准：溃疡性结肠炎：症状性97.34%（p =无显著性差异），内镜检查96.63%（p = 0.000），病理学90.26%（p = 0.000）。克罗恩病：放射学83.61%（p = 0.000）。克罗恩病的研究水平：57.57（p = 0.0005）。家族史：8.4%。诊断时溃疡性结肠炎最常见的受累部位仅为直肠炎，占13.6%，直肠和乙状结肠占26%，左半结肠炎占26%，全结肠炎占20%，而克罗恩病仅累及结肠的占16.7%，累及末端回肠的占30.3%，累及回结肠的占41.3%。这也有助于解释基于社区的研究中所观察到的严重程度、手术需求和生存率的差异。
我们强调了炎症性肠病在类型和性别分布上的一致性。家族性克罗恩病的高发病率提示存在遗传易感性。突出显示克罗恩病在手术需求方面发病率更高，但死亡率低于溃疡性结肠炎。
