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炎症性肠病:对716名智利当地患者的描述性研究。

Inflammatory bowel disease: A descriptive study of 716 local Chilean patients.

作者信息

Simian Daniela, Fluxá Daniela, Flores Lilian, Lubascher Jaime, Ibáñez Patricio, Figueroa Carolina, Kronberg Udo, Acuña Raúl, Moreno Mauricio, Quera Rodrigo

机构信息

Daniela Simian, Academic Research Unit, Clínica Las Condes, Santiago 7591046, Chile.

出版信息

World J Gastroenterol. 2016 Jun 14;22(22):5267-75. doi: 10.3748/wjg.v22.i22.5267.

Abstract

AIM

To demographically and clinically characterize inflammatory bowel disease (IBD) from the local registry and update data previously published by our group.

METHODS

A descriptive study of a cohort based on a registry of patients aged 15 years or older who were diagnosed with IBD and attended the IBD program at Clínica Las Condes in Santiago, Chile. The registry was created in April 2012 and includes patients registered up to October 2015. The information was anonymously downloaded in a monthly report, and the information on patients with more than one visit was updated. The registry includes demographic, clinical and disease characteristics, including the Montreal Classification, medical treatment, surgeries and hospitalizations for crisis. Data regarding infection with Clostridium difficile (C. difficile) were incorporated in the registry in 2014. Data for patients who received consultations as second opinions and continued treatment at this institution were also analyzed.

RESULTS

The study included 716 patients with IBD: 508 patients (71%) were diagnosed with ulcerative colitis (UC), 196 patients (27%) were diagnosed with Crohn's disease (CD) and 12 patients (2%) were diagnosed with unclassifiable IBD. The UC/CD ratio was 2.6/1. The median age was 36 years (range 16-88), and 58% of the patients were female, with a median age at diagnosis of 29 years (range 5-76). In the past 15 years, a sustained increase in the number of patients diagnosed with IBD was observed, where 87% of the patients were diagnosed between the years 2001 and 2015. In the cohort examined in the present study, extensive colitis (50%) and colonic involvement (44%) predominated in the patients with UC and CD, respectively. In CD patients, non-stricturing/non-penetrating behavior was more frequent (80%), and perianal disease was observed in 28% of the patients. There were significant differences in treatment between UC and CD, with a higher use of corticosteroids, and immunosuppressive and biological therapies was observed in the patients with CD (P < 0.05 and P < 0.01). Significant surgical differences were also observed: 5% of the UC patients underwent surgery, whereas 38% of the CD patients required at least one surgery (P < 0.01). The patients with CD were hospitalized more often during their disease course than the patients with UC (55% and 35% of the patients, respectively; P < 0.01). C. difficile infection was acquired by 5% of the patients in each group at some point during the disease course. Nearly half of the patients consulted at the institution for a second opinion, and 32% of these individuals continued treatment at the institution.

CONCLUSION

IBD has continued to increase in the study cohort, slowly approaching the level reported in developed countries.

摘要

目的

根据本地登记处的数据,对炎症性肠病(IBD)进行人口统计学和临床特征分析,并更新我们团队之前发表的数据。

方法

基于智利圣地亚哥拉斯孔德斯诊所IBD项目中15岁及以上被诊断为IBD的患者登记册进行队列描述性研究。该登记册于2012年4月创建,包括截至2015年10月登记的患者。信息每月以匿名报告形式下载,多次就诊患者的信息会更新。登记册包括人口统计学、临床和疾病特征,包括蒙特利尔分类、药物治疗、手术及危机时的住院情况。2014年将艰难梭菌感染数据纳入登记册。还分析了在该机构接受二次诊断咨询并继续治疗的患者数据。

结果

该研究纳入716例IBD患者:508例(71%)被诊断为溃疡性结肠炎(UC),196例(27%)被诊断为克罗恩病(CD),12例(2%)被诊断为无法分类的IBD。UC/CD比例为2.6/1。中位年龄为36岁(范围16 - 88岁),58%的患者为女性,诊断时的中位年龄为29岁(范围5 - 76岁)。在过去15年中,观察到IBD诊断患者数量持续增加,其中87%的患者在2001年至2015年期间被诊断。在本研究队列中,UC患者以广泛性结肠炎(50%)为主,CD患者以结肠受累(44%)为主。在CD患者中,非狭窄/非穿透性行为更常见(80%),28%的患者有肛周疾病。UC和CD在治疗上有显著差异,CD患者使用皮质类固醇、免疫抑制和生物疗法的比例更高(P < 0.05和P < 0.01)。手术方面也有显著差异:5%的UC患者接受了手术,而38%的CD患者至少需要一次手术(P < 0.01)。CD患者在病程中住院的频率高于UC患者(分别为55%和35%的患者;P < 0.01)。每组5%的患者在病程中的某个时间点获得了艰难梭菌感染。近一半的患者在该机构进行二次诊断咨询,其中32%的人在该机构继续治疗。

结论

在研究队列中IBD持续增加,正缓慢接近发达国家报告的水平。

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