Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Department of Pediatrics and.
J Crohns Colitis. 2017 Feb;11(2):157-164. doi: 10.1093/ecco-jcc/jjw146. Epub 2016 Sep 20.
Although paediatric Crohn's disease [CD] has a different phenotype and clinical course to adult CD, its clinical features and surgical risks are poorly defined, especially in Asian countries. The aim of this study was to investigate the clinical features and long-term outcomes of paediatric CD in a Korean population.
We retrospectively analysed 594 patients who were younger than 18 years of age at CD diagnosis between 1987 and 2013. Patient characteristics at diagnosis according to the Paris classification and clinical courses were analysed.
The male-to-female ratio was 2.4:1 and the median age at CD diagnosis was 15 years [range, 2-17 years]. A positive first-degree family history of inflammatory bowel disease was present in 30 patients [5.1%]. Sixty-seven patients [11.3%] showed growth impairment. The cumulative probabilities of perianal fistula at 1, 5 and 10 years after diagnosis were 50.3%, 54.9% and 57.6%, respectively. The cumulative probabilities of anti-tumour necrosis factor treatment at 1, 5, 10 and 20 years after diagnosis were 10.7%, 25.8%, 41.8% and 76.3%, respectively. The cumulative probabilities of intestinal resection at 1, 5, 10 and 20 years after diagnosis were 4.5%, 17.2%, 33.9% and 62.9 %, respectively. In multivariate analysis, complicated behaviour and isolated colonic location [L2] at diagnosis were associated with an increased and decreased risk of intestinal resection, respectively.
Our study is the largest Asian paediatric study which applied the Paris classification to patients. This study provides detailed information on disease phenotype and long-term clinical outcomes in a large cohort of Asian children with CD.
尽管儿童克罗恩病（CD）的表型和临床病程与成人 CD 不同，但在亚洲国家，其临床特征和手术风险仍未得到充分定义。本研究旨在调查韩国人群中儿童 CD 的临床特征和长期结局。
我们回顾性分析了 1987 年至 2013 年间诊断为 CD 时年龄小于 18 岁的 594 例患者。根据巴黎分类分析了患者在诊断时的特征和临床病程。
男女比例为 2.4:1，CD 诊断时的中位年龄为 15 岁[范围：2-17 岁]。30 例（5.1%）存在炎症性肠病一级家族史。67 例（11.3%）存在生长障碍。诊断后 1、5 和 10 年的肛周瘘累计概率分别为 50.3%、54.9%和 57.6%。诊断后 1、5、10 和 20 年的抗 TNF 治疗累计概率分别为 10.7%、25.8%、41.8%和 76.3%。诊断后 1、5、10 和 20 年的肠切除术累计概率分别为 4.5%、17.2%、33.9%和 62.9%。多变量分析显示，诊断时的复杂行为和孤立结肠病变（L2）与肠切除术风险的增加和降低相关。
本研究是应用巴黎分类对患者进行分析的最大亚洲儿童 CD 研究。本研究为亚洲儿童 CD 的大样本队列提供了疾病表型和长期临床结局的详细信息。
