Digestive Endoscopy Center, Department of Gastroenterology, Changhai Hospital, Second Military Medical University, Shanghai, China.
J Gastroenterol Hepatol. 2011 Apr;26(4):678-82. doi: 10.1111/j.1440-1746.2010.06586.x.
The epidemiology of lower gastrointestinal bleeding (LGIB) in Western populations has been reported; however, there are scant Asian reports. The aim of the present study was to determine the etiology of LGIB in a Chinese population by reporting a retrospective case series and a systematic analysis of Chinese literature.
A large colonoscopy database in a tertiary endoscopic center was searched to identify all patients with the indication of LGIB. The data, including patients' sex, age, endoscopic and pathological findings, were collected and analyzed. A comprehensive database search of the Chinese literature was carried out to obtain all relevant studies.
In our series, a total of 720 patients with LGIB were included. There were 425 males and 295 females with a median age of 50 years, the most common etiologies of LGIB were inflammatory bowel disease (IBD; 30.2%), polyps (23.4%) and cancer (10.7%). In 30.2% of all the patients, no obvious causes were identified. A systematic analysis of Chinese literature found an additional 160 studies providing relevant data in 53,951 patients. Overall, colorectal cancer (24.4%), colorectal polyps (24.1%), colitis (16.8%), anorectal disease (9.8%) and IBD (9.5%) were the most common etiologies of LGIB. The main etiologies were different between adults, the elderly and children.
The study shows colorectal cancer, colorectal polyps, colitis, anorectal disease and IBD were the most common etiologies of LGIB in the Chinese adult and elderly population, whereas colorectal polyps, chronic colitis and intussusception were the main causes of LGIB in Chinese children. Whereas diverticulum, the most common cause of LGIB in Western populations, is uncommon in China.
西方人群的下消化道出血（LGIB）的流行病学已有报道，但亚洲地区的报告较少。本研究旨在通过报告一系列回顾性病例和对中文文献的系统分析，确定中国人群中 LGIB 的病因。
在一家三级内镜中心的大型结肠镜数据库中搜索所有因 LGIB 指征而行结肠镜检查的患者。收集并分析患者的性别、年龄、内镜和病理发现等数据。对中文文献进行全面数据库检索，以获取所有相关研究。
在本系列中，共纳入 720 例 LGIB 患者。其中男 425 例，女 295 例，中位年龄 50 岁，LGIB 的最常见病因是炎症性肠病（IBD；30.2%）、息肉（23.4%）和癌症（10.7%）。在所有患者中，有 30.2%的患者未明确病因。对中文文献的系统分析发现，另有 160 项研究提供了 53951 例患者的相关数据。总体而言，结直肠癌（24.4%）、结直肠息肉（24.1%）、结肠炎（16.8%）、肛门直肠疾病（9.8%）和 IBD（9.5%）是 LGIB 的最常见病因。不同年龄段的主要病因不同。
本研究表明，结直肠癌、结直肠息肉、结肠炎、肛门直肠疾病和 IBD 是中国成年和老年人群 LGIB 的最常见病因，而结直肠息肉、慢性结肠炎和肠套叠是中国儿童 LGIB 的主要病因。而在西方人群中，最常见的 LGIB 病因憩室在我国则不常见。
