Probert C S, Jayanthi V, Wicks A C, Carr-Locke D L, Garner P, Mayberry J F
Leicester General Hospital.
Gut. 1992 Aug;33(8):1085-8. doi: 10.1136/gut.33.8.1085.
A retrospective, epidemiological study of abdominal tuberculosis in the city of Leicester from 1972 to 1989 is reported. Potential cases were identified from hospital medical records and endoscopy lists, in addition to the county notification register. The city population of 280,000 included over 75,000 South Asians. There were 146 cases among South Asians and six in Europeans, four of whom were British. The standardised incidence of abdominal tuberculosis in South Asians decreased significantly from 22.3 cases/10(5)/year during the 1970s to 9.2 cases/10(5)/year in the 1980s (chi 2 = 42, p < 0.001). The incidence during the 1980s was 10.7/10(5)/year in Hindus, 8.7/10(5)/year in Sikhs, and 4.6/10(5)/year in Muslims. The relative risk to Hindus was 2.3 fold greater, and for Sikhs 1.9 fold greater, than that for Muslims, a finding similar to that in pulmonary tuberculosis. The standardised incidence in Europeans was 0.2/10(5)/year and they had significantly less abdominal tuberculosis than South Asians (Z = 8.6, p < 0.001 and relative risk = 46). The standardised mortality ratio was significantly increased in Europeans (standardised mortality ratio = 755, 95% confidence interval 90-2730, chi 2 = 11.4, p < 0.001), but not in South Asians (standardised mortality ratio = 68, 95% confidence interval 20-160). Resection rates were similar between the two ethnic groups. Abdominal tuberculosis still occurs among migrants, and clinicians should remain alert to this in South Asians.
本文报告了一项对1972年至1989年莱斯特市腹部结核的回顾性流行病学研究。除了郡级通报登记册外,还从医院病历和内镜检查名单中识别出潜在病例。该市28万人口中包括超过7.5万南亚人。南亚人中有146例病例,欧洲人中有6例,其中4例是英国人。南亚人腹部结核的标准化发病率从20世纪70年代的22.3例/10⁵/年显著下降至20世纪80年代的9.2例/10⁵/年(χ² = 42,p < 0.001)。20世纪80年代,印度教徒的发病率为10.7/10⁵/年,锡克教徒为8.7/10⁵/年,穆斯林为4.6/10⁵/年。印度教徒的相对风险比穆斯林高2.3倍,锡克教徒比穆斯林高1.9倍,这一发现与肺结核相似。欧洲人的标准化发病率为0.2/10⁵/年,他们的腹部结核明显少于南亚人(Z = 8.6,p < 0.001,相对风险 = 46)。欧洲人的标准化死亡率显著升高(标准化死亡率 = 755,95%置信区间90 - 2730,χ² = 11.4,p < 0.001),但南亚人没有(标准化死亡率 = 68,95%置信区间20 - 160)。两个种族群体的切除率相似。移民中仍有腹部结核发生,临床医生对南亚人应保持警惕。