Howarth L J, Wiskin A E, Griffiths D M, Afzal N A, Beattie R M
Paediatric Medical Unit, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, United Kingdom.
Acta Paediatr. 2007 Dec;96(12):1790-3. doi: 10.1111/j.1651-2227.2007.00515.x. Epub 2007 Oct 30.
Ulcerative Colitis (UC) has an incidence of 1.4 per 100,000 in childhood. There is a paucity of data regarding outcome particularly with the increased use of early immunosuppression. This study reviews outcome at 2 years in a cohort with UC referred to a single centre.
Patients were recruited on the basis of a diagnosis made between 2000 and 2003 as a consecutive cohort. All had UC according to standard clinicopathological criteria. Children with indeterminate colitis were excluded. Follow-up data was collected at 2 years by case notes review.
Thirty-two children are reported. The median age at diagnosis was 11 years (range 2-16). All were treated with corticosteroids and 5-ASA derivatives at diagnosis. The majority of patients (94%, 30/32) received more than one course of steroids. By 2 years azathioprine use was high with 75% (24/32) of patients on treatment for steroid-dependent disease. There were 6 extra-intestinal manifestations and 8 disease related complications occurring in 12 patients (38%). The colectomy rate was 9% (3/32) for unresponsive disease.
There is a high need for Azathioprine in childhood UC. Colectomy rate at 2 years was around 10%. Extra-intestinal manifestations and disease related complications are common.
儿童溃疡性结肠炎（UC）的发病率为每10万人中有1.4例。关于其预后的数据匮乏，尤其是随着早期免疫抑制使用的增加。本研究回顾了转诊至单一中心的UC队列2年时的预后情况。
以2000年至2003年间确诊的连续队列招募患者。根据标准临床病理标准，所有患者均患有UC。排除不确定性结肠炎患儿。通过病历回顾收集2年时的随访数据。
报告了32名儿童。诊断时的中位年龄为11岁（范围2 - 16岁）。所有患者在诊断时均接受了皮质类固醇和5 - ASA衍生物治疗。大多数患者（94%，30/32）接受了不止一个疗程的类固醇治疗。到2年时，硫唑嘌呤的使用率很高，75%（24/32）的患者因类固醇依赖疾病接受治疗。12名患者（38%）出现了6种肠外表现和8种疾病相关并发症。无反应性疾病的结肠切除率为9%（3/32）。
儿童UC对硫唑嘌呤的需求很高。2年时的结肠切除率约为10%。肠外表现和疾病相关并发症很常见。
