Abdelrazeq A S, Kandiyil N, Botterill I D, Lund J N, Reynolds J R, Holdsworth P J, Leveson S H
Department of General Surgery, York Hospital, York, UK.
Colorectal Dis. 2008 Oct;10(8):805-13. doi: 10.1111/j.1463-1318.2007.01413.x. Epub 2007 Nov 14.
This study was undertaken to evaluate the cumulative incidence, onset and risk predicting factors for acute and chronic pouchitis.
A consecutive series of patients (n = 210), who underwent restorative proctocolectomy (RPC) and had a minimum follow-up of 12 months was reviewed. The cumulative incidence and onset of pouchitis was determined. Univariate analysis, followed by logistic regression analysis was used to evaluate the association of various demographic, clinical and histopathologic variables with the subsequent development of acute and chronic pouchitis.
A total of 198 patients were included. The mean follow-up was 64 months (range, 12-180). Sixty-four patients (32%) developed pouchitis, 35 acute and 29 chronic. The first episode of pouchitis occurred within the first year in 70% of cases. The presence of backwash ileitis (OR, 2.6; P = 0.015), primary sclerosing cholangitis (PSC; OR, 2; P = 0.018) and the duration of follow-up (OR, 1.1; P = 0.043) were associated with a higher incidence of pouchitis. The duration of follow-up was the only variable associated with acute pouchitis (P = 0.007). The presence of backwash ileitis and PSC were independent risk factors for chronic pouchitis (OR, 5.9; P < 0.001; OR, 2.8; P = 0.001 respectively).
Pouchitis is a heterogeneous disease which tends to occur early after restoration of gastrointestinal continuity. Patients with backwash ileitis and/or PSC are at considerable risk of developing chronic pouchitis. The strong association between backwash ileitis, PSC and chronic pouchitis suggests a common link in their pathogenesis.
本研究旨在评估急性和慢性袋炎的累积发病率、发病情况及风险预测因素。
回顾了一系列连续的患者（n = 210），这些患者接受了结直肠切除术后回肠储袋肛管吻合术（RPC），且至少随访了12个月。确定了袋炎的累积发病率和发病情况。采用单因素分析，随后进行逻辑回归分析，以评估各种人口统计学、临床和组织病理学变量与急性和慢性袋炎后续发生之间的关联。
共纳入198例患者。平均随访时间为64个月（范围为12 - 180个月）。64例患者（32%）发生了袋炎，其中35例为急性，29例为慢性。70%的病例在第一年内出现了袋炎的首次发作。反流性回肠炎（OR，2.6；P = 0.015）（原译作“反流性回肠炎”）、原发性硬化性胆管炎（PSC；OR，2；P = 0.018）和随访时间（OR，1.1；P = 0.043）与袋炎的较高发病率相关。随访时间是与急性袋炎相关的唯一变量（P = 0.007）。反流性回肠炎和PSC的存在是慢性袋炎的独立危险因素（分别为OR，5.9；P < 0.001；OR，2.8；P = 0.001）。
袋炎是一种异质性疾病，往往在胃肠道连续性恢复后早期发生。患有反流性回肠炎和/或PSC的患者发生慢性袋炎的风险相当高。反流性回肠炎、PSC与慢性袋炎之间的密切关联表明它们在发病机制上有共同联系。
