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2005-2009 年瑞典乌普萨拉地区炎症性肠病队列(ICURE)研究:第一年克罗恩病的发病情况及临床病程。

Incidence and clinical course of Crohn's disease during the first year - results from the IBD Cohort of the Uppsala Region (ICURE) of Sweden 2005-2009.

机构信息

Department of Internal Medicine, Falu Hospital, Falun, Sweden.

Department of Internal Medicine, Mariehamn, Åland, Finland.

出版信息

J Crohns Colitis. 2014 Mar;8(3):215-22. doi: 10.1016/j.crohns.2013.08.009. Epub 2013 Sep 12.

Abstract

BACKGROUND AND AIMS

As a part of the Swedish ICURE study where the epidemiological results of ulcerative colitis and microscopic colitis recently have been published, we hereby present the corresponding figures for Crohn's disease.

METHODS

All patients diagnosed with Crohn's disease in Uppsala County (305,381 inhabitants) were prospectively registered during 2005-2006 and the same for all new patients with Crohn's disease in Uppsala Region (642,117 inhabitants) during 2007-2009.

RESULTS

264 patients with Crohn's disease were included. The mean annual incidence was 9.9/100,000/year (95% CI: 7.1-12.6). Incidence among children <17 years was 10.0/100,000/year (95% CI: 3.8-16.3). 51% of the patients had ileal involvement (L1: n=73, 28%. L2: n=129, 49%. L3: n=62, 23%, L4: n=47, 18%) and 23% had a stricturing or penetrating disease (B1: n=204, 77%. B2: n=34, 13%. B3: n=26, 10%. p: n=27, 10%). Intestinal resection rate during the first year was 12.5%. Patients with complicated disease had longer symptom duration before diagnosis compared to patients with non-complicated disease (median months 12.0, IQR: 3.0-24.0 vs 4.0, IQR: 2.0-12.0, p=0.0032). Patients 40 years or older had an increased risk for surgery (HR: 2.03, 95% CI: 1.01-4.08, p=0.0457).

CONCLUSIONS

The incidence of Crohn's disease in a region of Sweden is one of the highest reported in Europe. Long symptom duration precedes stricturing or penetrating behaviour. Old age is an independent risk factor for surgery.

摘要

背景与目的

作为瑞典 ICURE 研究的一部分,溃疡性结肠炎和显微镜下结肠炎的流行病学结果最近已经公布,在此我们呈现相应的克罗恩病数据。

方法

2005-2006 年期间,乌普萨拉县(305381 居民)前瞻性登记所有确诊为克罗恩病的患者,2007-2009 年期间,乌普萨拉地区(642117 居民)所有新诊断的克罗恩病患者也同样如此。

结果

共纳入 264 例克罗恩病患者。年平均发病率为 9.9/100000/年(95%CI:7.1-12.6)。<17 岁儿童的发病率为 10.0/100000/年(95%CI:3.8-16.3)。51%的患者有回肠受累(L1:n=73,28%;L2:n=129,49%;L3:n=62,23%;L4:n=47,18%),23%有狭窄或穿透性疾病(B1:n=204,77%;B2:n=34,13%;B3:n=26,10%;p=27,10%)。第一年肠切除术率为 12.5%。与无并发症的患者相比,患有并发症的患者在诊断前有更长的症状持续时间(中位数月数 12.0,IQR:3.0-24.0 与 4.0,IQR:2.0-12.0,p=0.0032)。40 岁及以上的患者手术风险增加(HR:2.03,95%CI:1.01-4.08,p=0.0457)。

结论

瑞典一个地区的克罗恩病发病率是欧洲报道的最高之一。较长的症状持续时间先于狭窄或穿透性行为。年龄较大是手术的独立危险因素。

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