Zhou Ying, Huang Ying
Department of Gastroenterology, Children's Hospital of Fudan University, Shanghai 201102, P.R. China.
Exp Ther Med. 2016 Nov;12(5):3363-3368. doi: 10.3892/etm.2016.3756. Epub 2016 Sep 28.
To present study reports the clinical characteristics, diagnosis and management of pediatric patients with inflammatory bowel disease (IBD) in China. Clinical records of 49 pediatric patients with IBD at Fudan University Children's Hospital (Shanghai, China) between July 2001 and May 2012 were reviewed. Of 49 patients (30 males and 19 females), 8 patients had ulcerative colitis (UC) and 41 patients had Crohn's disease (CD). The mean age was 10.4 years in patients with UC and 10.1 years in patients with CD. The percentages of patients with UC with abdominal pain, diarrhea or rectal bleeding were 62.5, 100 and 87.5%, respectively, and that of CD patients were 75.6, 61 and 39%, respectively. Patients with UC were underweight (37.5%), and had oral ulcers (12.5%) and arthritis (12.5%), and patients with CD were underweight (34.1%), and had oral ulcers (26.8%), anal fistulas (22%) and arthritis (19.5%). Patients with CD had a higher proportion of immunoglobulin G, C-reactive protein and erythrocyte sedimentation rate compared with patients with UC. Histologic lesions of patients with UC were primarily located in the sigmoid colon (75%), transverse colon (50%) or pan-colon (50%), and in patients with CD they were located in the distal ileum (51.2%), ileocecum (58.5%) or upper gastrointestinal tract (41.5%). All patients underwent colonoscopies and 13 underwent double-balloon enteroscopies. Standard treatment for IBD, including corticosteroids, 5-aminosalicylate, and immunosuppressants (6-mercaptopurine and azathioprine), were administered to all patients. In addition 3 patients were treated with infliximab and 10 patients were treated with thalidomide. Comprehensive assessment of clinical, laboratory, endoscopic, and pathohistological data will benefit the timely diagnosis of IBD.
本研究报告了中国儿童炎症性肠病(IBD)患者的临床特征、诊断及治疗情况。回顾了2001年7月至2012年5月期间复旦大学附属儿科医院(中国上海)49例儿童IBD患者的临床记录。49例患者(30例男性,19例女性)中,8例患有溃疡性结肠炎(UC),41例患有克罗恩病(CD)。UC患者的平均年龄为10.4岁,CD患者的平均年龄为10.1岁。UC患者中腹痛、腹泻或直肠出血的比例分别为62.5%、100%和87.5%,CD患者的比例分别为75.6%、61%和39%。UC患者体重过轻(37.5%),有口腔溃疡(12.5%)和关节炎(12.5%),CD患者体重过轻(34.1%),有口腔溃疡(26.8%)、肛瘘(22%)和关节炎(19.5%)。与UC患者相比,CD患者的免疫球蛋白G、C反应蛋白和红细胞沉降率比例更高。UC患者的组织学病变主要位于乙状结肠(75%)、横结肠(50%)或全结肠(50%),CD患者的病变位于回肠末端(51.2%)、回盲部(58.5%)或上消化道(41.5%)。所有患者均接受了结肠镜检查,13例接受了双气囊小肠镜检查。所有患者均接受了IBD的标准治疗,包括皮质类固醇、5-氨基水杨酸和免疫抑制剂(6-巯基嘌呤和硫唑嘌呤)。此外,3例患者接受了英夫利昔单抗治疗,10例患者接受了沙利度胺治疗。对临床、实验室、内镜及病理组织学数据进行综合评估将有助于IBD的及时诊断。