Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.
Inflamm Bowel Dis. 2013 Jan;19(1):99-105. doi: 10.1002/ibd.22991.
Crohn's disease (CD) and intestinal Behcet's disease (BD) are transmural inflammatory diseases with fluctuating courses characterized by repeated episodes of relapse and remission that often require operation or reoperation. However, no study has directly compared the long-term prognoses of these two diseases.
We reviewed the medical records of 332 patients with CD and 276 patients with intestinal BD who were regularly followed up at a single tertiary academic medical center in Korea between March 1986 and July 2010. The clinical outcomes after diagnosis and surgery were analyzed using the Kaplan-Meier method and log-rank test.
There were no significant differences in the cumulative probabilities of surgery (29.4% and 36.0% vs. 31.6% and 44.4% at 5 and 10 years, respectively: P = 0.287) or admission (66.1% and 73.8% vs. 59.0% and 69.2%, P = 0.259) between CD and intestinal BD. Furthermore, no differences were observed between the two diseases for the cumulative probabilities of postoperative clinical recurrence (P = 0.724) and reoperation (P = 0.770). However, the cumulative probabilities of corticosteroid use (63.8% and 76.6% vs. 42.6% and 59.4% at 5 and 10 years, respectively: P < 0.001) and immunosuppressant use (49.1% and 65.5% vs. 27.1% and 37.7%, P < 0.001) were significantly higher in CD patients than in intestinal BD patients.
There were no significant differences in the long-term clinical outcomes and postoperative prognoses between CD and intestinal BD, although CD patients required corticosteroid or immunosuppressant therapy more often than intestinal BD patients.
克罗恩病(CD)和肠型贝赫切特病(BD)是具有波动性病程的透壁性炎症性疾病,其特征为反复发作和缓解,常需要手术或再次手术。然而,尚无研究直接比较这两种疾病的长期预后。
我们回顾了 1986 年 3 月至 2010 年 7 月在韩国的一家三级学术医疗中心定期随访的 332 例 CD 患者和 276 例肠型 BD 患者的病历。使用 Kaplan-Meier 方法和对数秩检验分析诊断和手术后的临床结局。
在手术(分别为 29.4%和 36.0%与 31.6%和 44.4%,在 5 年和 10 年时;P = 0.287)或住院(分别为 66.1%和 73.8%与 59.0%和 69.2%,P = 0.259)的累积概率方面,CD 和肠型 BD 之间无显著差异。此外,两种疾病的术后临床复发(P = 0.724)和再次手术(P = 0.770)的累积概率也无差异。然而,皮质类固醇(分别为 63.8%和 76.6%与 42.6%和 59.4%,在 5 年和 10 年时;P < 0.001)和免疫抑制剂(分别为 49.1%和 65.5%与 27.1%和 37.7%,P < 0.001)的累积使用率在 CD 患者中显著高于肠型 BD 患者。
尽管 CD 患者比肠型 BD 患者更常需要皮质类固醇或免疫抑制剂治疗,但 CD 和肠型 BD 之间的长期临床结局和术后预后无显著差异。