Ye Byong Duk, Yang Suk-Kyun, Cho Yun Kyung, Park Sang Hyoung, Yang Dong-Hoon, Yoon Soon Man, Kim Kyung Jo, Byeon Jeong-Sik, Myung Seung-Jae, Yu Chang Sik, Kim Jin-Ho
Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
Scand J Gastroenterol. 2010 Oct;45(10):1178-85. doi: 10.3109/00365521.2010.497936.
Recent studies have suggested that the clinical characteristics and genetic background of Crohn's disease (CD) patients differ between Asian and Caucasian individuals. However, the clinical features and course of CD in Asian patients remain unclear. Therefore, we investigated the clinical features and long-term prognosis of CD in a Korean population.
We retrospectively analyzed 278 Korean patients with CD first diagnosed at the Asan Medical Center between March 1991 and February 2007.
The male-to-female ratio was 2.2:1 and the median age at diagnosis was 23 years. The median duration of follow-up was 71 months (range, 1-210 months). At diagnosis, 187 patients (67.3%) had disease in both small bowel and colon, 68 (24.4%) had isolated small bowel disease, and 23 (8.3%) had isolated colonic disease. The number of patients with stricturing or penetrating behavior as defined by the Montreal classification increased from 87 (31.3%) at diagnosis to 141 (50.7%) at final evaluation. One hundred and thirty patients (46.8%) experienced perianal fistulas before and/or after diagnosis of CD. A total of 71 patients (25.5%) underwent intestinal resection and the cumulative probability of intestinal resection after 1, 5, and 10 years was 15.5%, 25.0%, and 32.8%, respectively.
Korean CD patients differed from Western patients in gender distribution, disease location, and perianal fistula occurrence. Korean CD patients may also have better clinical courses than Western patients, as indicated by the lower intestinal resection rate.
近期研究表明，克罗恩病（CD）患者的临床特征和遗传背景在亚洲人和白种人之间存在差异。然而，亚洲患者CD的临床特征和病程仍不明确。因此，我们调查了韩国人群中CD的临床特征和长期预后。
我们回顾性分析了1991年3月至2007年2月在峨山医学中心首次诊断为CD的278例韩国患者。
男女比例为2.2:1，诊断时的中位年龄为23岁。中位随访时间为71个月（范围1 - 210个月）。诊断时，187例患者（67.3%）小肠和结肠均患病，68例（24.4%）为孤立性小肠疾病，23例（8.3%）为孤立性结肠疾病。根据蒙特利尔分类定义的狭窄或穿透行为患者数量从诊断时的87例（31.3%）增加到最终评估时的141例（50.7%）。130例患者（46.8%）在CD诊断之前和/或之后出现肛周瘘管。共有71例患者（25.5%）接受了肠切除术，1年、5年和10年后肠切除的累积概率分别为15.5%、25.0%和32.8%。
韩国CD患者在性别分布、疾病部位和肛周瘘管发生率方面与西方患者不同。韩国CD患者的临床病程可能也比西方患者更好，这一点从较低的肠切除率可以看出。
