Størdal Ketil, Jahnsen Jørgen, Bentsen Beint S, Moum Bjørn
Department of Paediatrics, Østfold Hospital, Fredrikstad, Norway.
Digestion. 2004;70(4):226-30. doi: 10.1159/000082893. Epub 2004 Dec 22.
Few prospective population-based studies have been carried out on the incidence of inflammatory bowel disease (IBD). In a population-based study of pediatric IBD in southeastern Norway, patients <16 years at the time of diagnosis were followed up prospectively. The study reports on changes in diagnosis and clinical outcome 5 years after diagnosis.
From 1990 to 1993 new cases of IBD were registered in a population of 174,482 children aged less than 16 years. The patients' diagnoses were systematically evaluated 1 year after diagnosis and the patients were followed up clinically for up to 5 years after diagnosis.
Sixteen cases of Crohn's disease (CD), 14 cases of ulcerative colitis (UC) and 3 cases of indeterminate colitis (IND) were initially registered. After 1 year IND were reclassified as UC (n=2) or CD (n=1). Altogether, 18% (6/33) had their diagnosis changed during the 5 years of follow-up, which yielded a mean annual incidence of 2.7/100,000 for CD and 2.0/100,000 for UC. Of the children with CD, more than 80% had relapses during the 5-year period, and 6 of 18 had surgery. Two-thirds of the children with UC had relapses during the 5-year period, and 3 patients underwent colectomy.
An incidence of 4.7/100,000 is comparable to that found in most other studies made in Europe. The relationship between UC and CD in children was found to differ from that in the adult population. One of 5 patients had their diagnosis changed during the follow-up period. Pediatric UC seems to have a more serious course of disease than in the adult IBD population, which may be explained by the higher risk of pancolitis at diagnosis.
关于炎症性肠病（IBD）发病率的前瞻性人群研究开展较少。在挪威东南部一项基于人群的儿童IBD研究中，对诊断时年龄小于16岁的患者进行了前瞻性随访。该研究报告了诊断后5年的诊断变化和临床结局。
1990年至1993年，在174,482名16岁以下儿童人群中登记了IBD新病例。在诊断后1年对患者的诊断进行系统评估，并在诊断后对患者进行长达5年的临床随访。
最初登记了16例克罗恩病（CD）、14例溃疡性结肠炎（UC）和3例不确定性结肠炎（IND）。1年后，IND被重新分类为UC（n = 2）或CD（n = 1）。在5年随访期间，共有18%（6/33）的患者诊断发生了变化，CD的年平均发病率为2.7/10万，UC为2.0/10万。在患有CD的儿童中，超过80%在5年期间复发，18例中有6例接受了手术。三分之二患有UC的儿童在5年期间复发，3例患者接受了结肠切除术。
4.7/10万的发病率与欧洲大多数其他研究结果相当。发现儿童UC和CD之间的关系与成人人群不同。五分之一的患者在随访期间诊断发生了变化。儿童UC似乎比成人IBD人群的病程更严重，这可能是由于诊断时全结肠炎风险较高所致。
