Department of Pediatrics, Children's Hospital, China Medical University Hospital, Taichung, Taiwan.
Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Miami Hospital, Miami, Florida, USA.
J Investig Med. 2018 Aug;66(6):998-1003. doi: 10.1136/jim-2017-000703. Epub 2018 Mar 26.
Early life events play a crucial role in the development of irritable bowel syndrome (IBS). Some evidence suggests the phenomenon of cross-organ sensitization between bladder and colon. Whether urinary tract infection (UTI) during infancy is a risk factor of childhood IBS remains to be elucidated. In this retrospective cohort study, we selected 31 788 infants who had UTI between 2000 and 2011 as a UTI cohort and selected 127 152 infants without UTI as a comparison cohort, matched by age, sex and level of urbanization of living area. Incidence density and HRs with CIs of IBS between UTI and non-UTI cohorts were calculated by the end of 2012. The incidence density of IBS during the study period was 1.52-fold higher in the UTI cohort (95% CI 1.38 to 1.67) compared with the non-UTI cohort (2.05 vs 1.32 per 10 000 person-years). The HR of IBS was slightly higher for boys (1.53; 95% CI 1.34 to 1.73) than for girls (1.50; 95% CI 1.29 to 1.73). The HRs for IBS in children with UTI were greater for those with more UTI-related medical visits/per year (>5 visits, HR 61.3; 95% CI 51.8 to 72.6), with longer length of stay of hospitalization (>7 days, HR 1.75; 95% CI 1.36 to 2.24) and with vesicoureteral reflux (VUR) (HR 1.73; 95% CI 1.35 to 2.22) (p<0.0001, the trend test). Infants with UTI had higher risks of childhood IBS and the risks elevated further with recurrent UTI or UTI with concurrent VUR.
早期生活事件在肠易激综合征（IBS）的发展中起着至关重要的作用。有证据表明，膀胱和结肠之间存在器官交叉敏感现象。婴儿期尿路感染（UTI）是否是儿童 IBS 的危险因素仍有待阐明。在这项回顾性队列研究中，我们选择了 2000 年至 2011 年间患有 UTI 的 31788 名婴儿作为 UTI 队列，并选择了 127152 名无 UTI 的婴儿作为对照队列，按年龄、性别和居住地城市化程度进行匹配。到 2012 年底，计算了 UTI 队列和非 UTI 队列中 IBS 的发病率密度和 HRs。与非 UTI 队列相比，研究期间 UTI 队列中 IBS 的发病率密度高 1.52 倍（95%CI 1.38 至 1.67）（2.05 比 1.32 每 10000 人年）。男孩（1.53；95%CI 1.34 至 1.73）患 IBS 的 HR 略高于女孩（1.50；95%CI 1.29 至 1.73）。UTI 儿童中 IBS 的 HRs 随着 UTI 相关医疗就诊次数/年的增加而增加（>5 次就诊，HR 61.3；95%CI 51.8 至 72.6），住院时间延长（>7 天，HR 1.75；95%CI 1.36 至 2.24）和伴有输尿管反流（VUR）（HR 1.73；95%CI 1.35 至 2.22）（p<0.0001，趋势检验）。患有 UTI 的婴儿患儿童 IBS 的风险较高，且随着反复 UTI 或伴有 VUR 的 UTI 风险进一步增加。
