Guan D X, Yu F H, Wang G L, Zhou J, Wang D Y, Nie X L, Xu X W
Department of Gastroenterology, Beijing Children's Hospital, Faculty of Digestive Diseases, Capital Medical University, National Clinical Research Center for Digestive Diseases, Beijing 100045, China.
Zhonghua Er Ke Za Zhi. 2017 Jul 2;55(7):493-498. doi: 10.3760/cma.j.issn.0578-1310.2017.07.005.
To investigate the clinical data of children with inflammatory bowel disease (IBD) retrospectively, including Crohn's disease (CD) and ulcerative colitis (UC) and identify the clinical characteristics and trends of change. Clinical data of hospitalized patients diagnosed as IBD in Beijing Children's Hospital from January 2000 to December 2014 were collected and retrospectively analyzed. Patients were divided into six groups based on type of disease and year of admission: Group A1(CD, 2000-2004) included 12 patients, Group B1(CD, 2005-2009) included 11, Group C1(CD, 2010-2014) included 51; Group A2(UC, 2000-2004) included 17, Group B2(UC, 2005-2009) included 25, Group C2(UC, 2010-2014) included 68. A total of 184 IBD patients were included in the study, 74 had CD and 110 had UC. The hospitalization constituent ratio of CD increased from 0.6/10 000 in Year 2000 to 2.9/10 000 in Year 2014. The hospitalization constituent ratio of UC increased from 0.5/10 000 in Year 2001 to 3.9/10 000 in Year 2014. The hospitalization constituent ratios of CD and UC both increased gradually(<0.05). Up to 61.4%(113/184) of IBD patients belong to early onset IBD, furthermore the very early onset IBD and infantile IBD accounted for 41.8%(77/184) and 26.6%(49/184) respectively. For CD, ileocolonic type(47.3%, 35/74) and non-structuring, non-penetrating type (67.6%, 50/74) were more common. Perianal disease occured in 31.1%(23/74) of CD patients; 81.1%(60/74) of CD patients had moderate/severe activity. For UC, pancolitis type(59.1%, 65/110) was more common. There were no significant changes for location of pathological change, disease behavior, activity degree of CD, extent of UC lesion and incidence of surgery, intestinal perforation and hemorrhage of gastrointestinal tract for IBD in the past 15 years(>0.05). Severe UC(S3) was more common in Group A2(64.7%, 11/17), but moderate UC(S2) was more common in Group C2(48.5%, 33/68), the difference was statistically significant (=0.001 7). During the past 15 years, the hospitalization constituent ratio for IBD in our hospital showed a growing trend. The ratio of infantile IBD and very early onset IBD was high. For CD, perianal disease was commonly seen and most patients had moderate/severe activity. The surgery rate and incidence of intestinal obstruction and perforation were higher in the CD patients than UC patients. For UC, the lesions were more extensively combined with higher disease activity.
回顾性分析炎症性肠病（IBD）患儿的临床资料，包括克罗恩病（CD）和溃疡性结肠炎（UC），并确定其临床特征及变化趋势。收集2000年1月至2014年12月在北京儿童医院确诊为IBD的住院患儿的临床资料并进行回顾性分析。根据疾病类型及入院年份将患儿分为6组：A1组（CD，2000 - 2004年）12例，B1组（CD，2005 - 2009年）11例，C1组（CD，2010 - 2014年）51例；A2组（UC，2000 - 2004年）17例，B2组（UC，2005 - 2009年）25例，C2组（UC，2010 - 2014年）68例。本研究共纳入184例IBD患儿，其中CD 74例，UC 110例。CD的住院构成比从2000年的0.6/万升至2014年的2.9/万。UC的住院构成比从2001年的0.5/万升至2014年的3.9/万。CD和UC的住院构成比均呈逐渐上升趋势（<0.05）。高达61.4%（113/184）的IBD患儿属于早发型IBD，其中极早发型IBD和婴儿型IBD分别占41.8%（77/184）和26.6%（49/184）。CD以回结肠型（47.3%，35/74）和非狭窄非穿透型（67.6%，50/74）最为常见。31.1%（23/74）的CD患儿出现肛周病变；81.1%（60/74）的CD患儿病情为中度/重度活动期。UC以全结肠炎型（59.1%，65/110）最为常见。过去15年IBD患儿的病变部位、疾病行为、CD的活动程度、UC病变范围及手术率、肠穿孔和消化道出血发生率均无显著变化（>0.05）。重度UC（S3）在A2组更为常见（64.7%，11/17），而中度UC（S2）在C2组更为常见（48.5%，33/68），差异有统计学意义（=0.001 7）。在过去15年中，我院IBD的住院构成比呈上升趋势。婴儿型IBD和极早发型IBD的比例较高。CD中肛周病变常见，多数患儿病情为中度/重度活动期。CD患儿的手术率、肠梗阻和肠穿孔发生率高于UC患儿。UC病变范围更广，疾病活动度更高。
