1st Department of Medicine, Semmelweis University, Budapest, Hungary.
J Crohns Colitis. 2011 Feb;5(1):5-13. doi: 10.1016/j.crohns.2010.08.004. Epub 2010 Sep 15.
Limited data are available on the incidence and disease course of IBD in the elderly population. Our aim was to analyze the incidence and disease course of IBD according to the age at diagnosis in the population-based Veszprem province database, which included incident patients diagnosed between January 1, 1977 and December 31, 2008.
Data of 1420 incident patients were analyzed (UC: 914, age at diagnosis: 38.9 SD 15.9 years; CD: 506, age at diagnosis: 31.5 SD 13.8 years). Both hospital and outpatient records were collected and comprehensively reviewed.
106 (11.6%) of UC patients and 21 (4.2%) of CD patients were diagnosed with >60 years of age. In UC, the incidence increased from 1.09 to 10.8/10(5) in the elderly, while CD increased to 3.04/10(5) in 2002-2007. In CD, colonic location (elderly: 61.9% vs. pediatric: 24.3%, p=0.001, and adults: 36.8%, p=0.02) and stenosing disease (elderly: 42.9% vs. pediatric: 14.9%, p=0.005, and adults: 19.5%, p=0.01) were more frequent in the elderly. A change in disease behavior was absent in the elderly, while in pediatric and adult CD population it was 20.3% (p=0.037), 19.8% (p=0.036) after 5 years. In UC, extensive disease was more frequent in pediatric patients compared to the elderly (p=0.003, OR: 2.73, 95%CI: 1.38-5.41). In addition, pediatric (57.3%, p<0.001, OR: 6.58; 95%CI: 3.22-12.9) and adult (39.8%, p<0.001, OR: 3.24; 95%CI: 1.91-5.49) patients required more often systemic steroids during follow-up compared to the elderly (17%). Proximal extension at 10 years was 11.6%, but time to extension was not different according to the age at onset.
Elderly patients represent an increasing proportion of the IBD population. Stenosing and colon-only disease were characteristic for elderly CD patients, while the disease course in UC was milder.
关于老年人中炎症性肠病（IBD）的发病率和疾病进程，目前数据有限。我们的目的是根据基于人群的韦斯普雷姆省数据库中诊断时的年龄分析 IBD 的发病率和疾病进程，该数据库包括 1977 年 1 月 1 日至 2008 年 12 月 31 日期间确诊的发病患者。
分析了 1420 名发病患者的数据（UC：914 名，诊断时的年龄：38.9 ± 15.9 岁；CD：506 名，诊断时的年龄：31.5 ± 13.8 岁）。收集并综合评估了医院和门诊记录。
106 名（11.6%）UC 患者和 21 名（4.2%）CD 患者的诊断年龄>60 岁。在 UC 中，发病率从 1.09 上升到 60 岁以上人群的 10.8/10（5），而 CD 在 2002-2007 年上升到 3.04/10（5）。在 CD 中，结肠部位（老年：61.9%比儿科：24.3%，p=0.001，成人：36.8%，p=0.02）和狭窄性疾病（老年：42.9%比儿科：14.9%，p=0.005，成人：19.5%，p=0.01）在老年患者中更为常见。老年患者的疾病行为没有变化，而在儿科和成人 CD 人群中，5 年后的变化分别为 20.3%（p=0.037）和 19.8%（p=0.036）。在 UC 中，与老年患者相比，儿科患者的广泛疾病更为常见（p=0.003，OR：2.73，95%CI：1.38-5.41）。此外，儿科（57.3%，p<0.001，OR：6.58；95%CI：3.22-12.9）和成人（39.8%，p<0.001，OR：3.24；95%CI：1.91-5.49）患者在随访期间更常需要全身皮质类固醇，而老年患者仅为 17%。10 年内近端扩展为 11.6%，但扩展时间与发病年龄无关。
老年患者在 IBD 人群中所占比例不断增加。狭窄和结肠疾病是老年 CD 患者的特征，而 UC 的疾病进程则较为温和。
