Sonnenberg A, Koch T R
Gastroenterology Section, Zablocki VA Medical Center, Milwaukee, Wisconsin 53295.
Dig Dis Sci. 1989 Nov;34(11):1720-9. doi: 10.1007/BF01540050.
To test the hypothesis that environmental factors play a role in idiopathic inflammatory bowel disease (IBD), age, period, and generation (cohort) effects on IBD mortality in the United Kingdom and the United States were examined. The crude death rate of ulcerative colitis has declined since 1930. Plotted versus the year of birth, its age-specific death rates showed an initial rise in successive generations born between 1850 and 1900, followed by a fall in all later generations. The crude death rate of Crohn's disease increased from 1950 to 1974 and then declined. When the age-specific death rates for Crohn's disease and ulcerative colitis were superimposed, the mortality from Crohn's disease in each age group or sex began to decline at a different time, but always upon reaching the level of mortality from ulcerative colitis. It appears as if the gradual disappearance of an ulcerative colitis-associated factor in a birth-cohort fashion prevented a further rise in mortality from Crohn's disease after 1974.
为检验环境因素在特发性炎症性肠病（IBD）中起作用这一假设，研究了英国和美国年龄、时期和代（队列）对IBD死亡率的影响。自1930年以来，溃疡性结肠炎的粗死亡率有所下降。按出生年份绘制，其年龄别死亡率显示，在1850年至1900年出生的连续几代人中最初上升，随后在所有后代中下降。克罗恩病的粗死亡率在1950年至1974年期间上升，然后下降。当将克罗恩病和溃疡性结肠炎的年龄别死亡率叠加时，各年龄组或性别的克罗恩病死亡率在不同时间开始下降，但总是在达到溃疡性结肠炎的死亡率水平时下降。似乎溃疡性结肠炎相关因素以出生队列的方式逐渐消失，阻止了1974年后克罗恩病死亡率的进一步上升。
