Lakatos László, Mester Gábor, Erdélyi Zsuzsanna, Balogh Mihály, Szipócs István, Kamarás György, Lakatos Péter László
Csolnoky F. Megyei Kórház, I. Belgyógyászati Osztály, Veszprém.
Orv Hetil. 2003 Sep 14;144(37):1819-27.
An epidemiological study of inflammatory bowel disease (IBD) in Veszprém county (located in western part of Hungary) was carried out from 1977 to 2001.
Both hospital and outpatient records of IBD patients were collected reviewed carefully. Most patients have been followed up regularly.
The number of population has decreased during the observed period from 386,000 to 376,000. The county has both industrial and agrarian parts. 560 new ulcerative colitis (UC) cases, 212 Crohn's disease (CD), and 40 indeterminate colitides (IC) were diagnosed in the investigated period. Incidence rate increased from 1.66 (1977-1981) to 11.01 (1997-2001) in UC, and from 0.41 to 4.68 in CD, respectively. The incidence rate in IC rose from 0.26 to 0.74. The M/F ratio in UC was 1.06, in CD: 1.03, respectively, 41 UD patients and 13 CD patients died, the cause of death was disease related in 6 UC and in 6 CD patients. The average age at death in UC was not different from that observed in general population (66.4 years) but in CD (50.1 years) it was much earlier. The disease related mortality was low, 0.06/100,000 both in UC and CD. The prevalence rate at the end of 2001 was 142.6 for UC and 52.9/100,000 inhabitants for CD. Mean age at onset in UC was 38.9 +/- 15.5 years, in CD 31.7 +/- 12.8 years. We observed only one peak onset of the diseases, in UC it was between 30 and 40 years, in CD between 20 and 30 years. People living in towns were more liable to acquire the disease (ORUC = 1.27, ORCD = 1.13). The rate of smokers at the onset was 14.3% (OR = 0.25) in UC and 50.5% (OR = 1.98) in CD. Ex-smokers were 18.4% and 6.4%. Family history of IBD was present in 3.4% in UC and 9.9% in CD. The location of UC (according to the known largest extent) was proctitis in 112 cases, proctosigmoiditis in 162 cases, left sided colitis in 117 and subtotal or pancolitis in 169 cases. The location of CD was only ileal in 68 cases, ileocolonic in 87 cases, colonic in 57 cases. The behaviour of CD was non-stricturing-non-penetrating in 63 cases, stricturing in 54 cases, penetrating in 95 cases. 59.4% of the CD patients had at least one operation, 6.1% had more than 3 operations.
The incidence and prevalence rates have increased steadily in Veszprém County, now it reaches that of most western European countries. There were no gender differences either in UC or CD. Smoking seemed to be a risk factor for CD, but it was preventive for UC. The rapid increase in incidence supports a role for environmental (e.g. diet, lifestyle changes) risk factors.
1977年至2001年期间，在匈牙利西部的维斯普雷姆县开展了一项炎症性肠病（IBD）的流行病学研究。
收集并仔细查阅了IBD患者的医院和门诊记录。大多数患者都得到了定期随访。
在观察期内，该县人口数量从38.6万减少至37.6万。该县既有工业区也有农业区。在调查期间，共诊断出560例新的溃疡性结肠炎（UC）病例、212例克罗恩病（CD）病例和40例不确定性结肠炎（IC）病例。UC的发病率从1977 - 1981年的1.66上升至1997 - 2001年的11.01，CD的发病率从0.41上升至4.68。IC的发病率从0.26上升至0.74。UC的男女比例为1.06，CD为1.03。41例UC患者和13例CD患者死亡，其中6例UC患者和6例CD患者的死因与疾病相关。UC患者的平均死亡年龄与普通人群（66.4岁）无差异，但CD患者（50.1岁）的平均死亡年龄要早得多。疾病相关死亡率较低，UC和CD均为0.06/10万。2001年底UC的患病率为142.6/10万，CD为52.9/10万居民。UC的平均发病年龄为38.9±15.5岁，CD为31.7±12.8岁。我们观察到疾病只有一个发病高峰，UC在30至40岁之间，CD在20至30岁之间。城镇居民更容易患病（UC的OR = 1.27，CD的OR = 1.13）。发病时吸烟者的比例在UC中为14.3%（OR = 0.25），在CD中为50.5%（OR = 1.98）。既往吸烟者分别为18.4%和6.4%。UC患者中有3.4%有IBD家族史，CD患者中有9.9%有IBD家族史。UC的病变部位（根据已知的最大范围），直肠炎112例，直肠乙状结肠炎162例，左侧结肠炎117例，次全结肠炎或全结肠炎169例。CD的病变部位，仅累及回肠68例，回结肠87例，结肠57例。CD的病变行为，非狭窄非穿透性63例，狭窄性54例，穿透性95例。59.4%的CD患者至少接受过一次手术，6.1%的患者接受过3次以上手术。
维斯普雷姆县的发病率和患病率稳步上升，现已达到大多数西欧国家的水平。UC和CD在性别上均无差异。吸烟似乎是CD的一个危险因素，但对UC有预防作用。发病率的快速上升支持环境（如饮食、生活方式改变）危险因素发挥了作用。
