Department of Surgery, University of Otago, Christchurch, New Zealand.
Dis Colon Rectum. 2012 Jul;55(7):773-7. doi: 10.1097/DCR.0b013e31825228b0.
Perianal Crohn's disease represents a phenotype distinct from luminal Crohn's disease and may follow a different course. To date, the only detailed classifications of perianal Crohn's disease arise from referral center cohorts that do not reflect the spectrum of disease in the population as a whole.
The aim of this study was to document the rate, classification, and time course of symptomatic perianal Crohn's disease in a population-based cohort.
This is a population-based cohort study.
: This study was conducted in the Canterbury region of New Zealand.
All patients with IBD in Canterbury, New Zealand, were eligible for recruitment over a 3-year period.
The clinical records of all patients with Crohn's disease were reviewed, and all symptomatic perianal disease was classified according to the American Gastroenterological Society position statement. The rate of perianal involvement and timing of onset relative to Crohn's diagnosis was determined.
Ninety-one percent of IBD patients in the region were recruited. Seven hundred fifteen patients had Crohn's disease, of which 190 (26.6%) patients had symptomatic perianal disease. The median age of patients with perianal disease was 37 years (range, 4-82 years) and 58.4% were female. Median follow-up was 9 years (range, 2 months to 45 years) from Crohn's disease diagnosis. Onset of perianal disease ranged from 18 years pre-Crohn's diagnosis to 33 years post-Crohn's diagnosis. Fistulas were the most common lesion (50% of patients), followed by perianal abscesses (42.1%), fissures (32.6%), skin tags (11.1%), strictures (7.4%), and hemorrhoids (1.6%). The cumulative probability at 20 years of any perianal Crohn's disease was 42.7% and of a perianal fistula 28.3%.
This study assumed all noted perianal lesions were related to Crohn's disease and the retrospective classification may have been inaccurate in some cases.
This study provides the first detailed classification of perianal Crohn's disease in a population-based cohort.
肛周克罗恩病是一种与肠内克罗恩病不同的表型，可能具有不同的病程。迄今为止，唯一详细的肛周克罗恩病分类来自转诊中心队列，这些分类并不能反映整个人群中疾病的全貌。
本研究旨在记录人群中肛周克罗恩病的发病率、分类和时间进程。
这是一项基于人群的队列研究。
本研究在新西兰坎特伯雷地区进行。
在新西兰坎特伯雷地区，所有患有炎症性肠病的患者均有资格在 3 年期间内入组。
对所有克罗恩病患者的临床记录进行了回顾，并根据美国胃肠病学会的立场声明对所有有症状的肛周疾病进行了分类。确定肛周受累的发病率和相对于克罗恩病诊断的发病时间。
该地区 91%的炎症性肠病患者被招募。715 例患者患有克罗恩病，其中 190 例（26.6%）患者患有症状性肛周疾病。肛周疾病患者的中位年龄为 37 岁（范围为 4-82 岁），58.4%为女性。从克罗恩病诊断开始的中位随访时间为 9 年（范围为 2 个月至 45 年）。肛周疾病的发病时间范围从克罗恩病诊断前 18 年到克罗恩病诊断后 33 年。肛瘘是最常见的病变（50%的患者），其次是肛周脓肿（42.1%）、肛裂（32.6%）、皮肤标签（11.1%）、狭窄（7.4%）和痔疮（1.6%）。20 年内任何肛周克罗恩病的累积概率为 42.7%，肛周瘘的累积概率为 28.3%。
本研究假设所有记录的肛周病变均与克罗恩病有关，在某些情况下，回顾性分类可能不准确。
本研究提供了人群中肛周克罗恩病的首次详细分类。
