Law Siu-Tong, Li Kin Kong
Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong. Correspondence to: Dr Siu-tong LAW, Division of Gastroenterology and Hepatology, Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, Hong Kong.
Indian Pediatr. 2013 Dec;50(12):1148-52. doi: 10.1007/s13312-013-0301-z. Epub 2013 Jul 5.
The aim of this study was to compare the clinical characteristics and treatment outcomes of patients with young and adult onset Crohns disease. Among 79 consecutive Crohns disease patients (11 (13.92%) with onset =16 years old), young onset Crohns disease was significantly associated with fever (36.36 vs. 14.71%, P 0.041), weight loss (72.7 vs. 29.4%, P 0.003), isolated abdominal pain (45.45 vs. 16.18%, P 0.013), lower body mass index ( 17.32 vs. 21.29 kgm2, P 0.019), and extraintestinal manifestation, particularly oral (45.5% vs. 22.1%, P 0.049) and perianal lesion (63.6% vs. 36.8%, P 0.046). In both groups, ileocolonic disease and inflammatory lesion were the most prevalent site of involvement and dominant disease behavior respectively. Their complication and bowel resection rate were similar but the former took a longer period of time to develop in the young onset group (84 vs. 24 month, P 0.018). Cox proportional hazard regression analysis revealed that active smoking and delayed use of immunosuppressive therapy were the only independent risk factors associated with increased risk of complications.
本研究的目的是比较青少年起病和成人起病的克罗恩病患者的临床特征及治疗结果。在79例连续的克罗恩病患者中(11例(13.92%)起病年龄≤16岁),青少年起病的克罗恩病与发热(36.36%对14.71%,P = 0.041)、体重减轻(72.7%对29.4%,P = 0.003)、单纯腹痛(45.45%对16.18%,P = 0.013)、较低的体重指数(17.32对21.29kg/m2,P = 0.019)以及肠外表现,尤其是口腔病变(45.5%对22.1%,P = 0.049)和肛周病变(63.6%对36.8%,P = 0.046)显著相关。在两组中,回结肠疾病和炎症性病变分别是最常见的受累部位和主要的疾病行为。它们的并发症和肠切除率相似,但青少年起病组并发症出现的时间更长(84个月对24个月,P = 0.018)。Cox比例风险回归分析显示,主动吸烟和延迟使用免疫抑制治疗是与并发症风险增加相关的仅有的独立危险因素。