Pediatric Gastroenterology, Department of Pediatrics, KK Women's and Children's Hospital, Singapore.
Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Khoo Teck Puat-National University Children's Medical Institute, National University Health System, Singapore.
J Dig Dis. 2018 Jul;19(7):395-403. doi: 10.1111/1751-2980.12641. Epub 2018 Jul 23.
Epidemiological studies on pediatric-onset inflammatory bowel disease (PIBD) are scarce in South-East Asia (SEA). This study aimed to evaluate the incidence trend and clinical characteristics of PIBD in a SEA cohort in Singapore over 22 years (1994-2015).
Case records of PIBD ≤18 years from the only two tertiary pediatric hospitals in Singapore were reviewed. The mean annual incidence (MAI) of PIBD was calculated based on Singapore's age-specific population data.
Overall MAI of PIBD was 1.26 per 100 000 (95% confidence interval [CI] 0.56-1.96). During the first decade (1994-2004) MAI was 0.23 per 100 000 (95% CI 0.08-0.39); this rose almost 10-fold to 2.28 per 100 000 (95% CI 1.15-3.41) during the second decade (2005-2015). Linear regression analysis showed significant increase in MAI over the 22-year period (r = 0.826, P < 0001). Of the 228 patients, 61.0% had Crohn's disease (CD), 30.3% ulcerative colitis and 8.7% IBD-unclassified, with a mdian age at diagnosis of 10.47 years and a male predominance (58.3%); 37.7% of them aged <10 years at diagnosis and 17.5% were very early-onset IBD. In CD, 27.3% had stricturing and/or penetrating disease and 21.6% were with perianal disease. Indians had a disproportionately high representation while positive family history was rare (1.3%).
Although PIBD is uncommon in Singapore, its incidence has risen dramatically over recent decades. A younger age of disease onset and higher proportions of perianal and stricturing/penetrating diseases suggest more aggressive disease than in Western data.
儿科炎症性肠病（PIBD）的流行病学研究在东南亚（SEA）很少见。本研究旨在评估新加坡 22 年来（1994-2015 年） SEA 队列中 PIBD 的发病趋势和临床特征。
回顾了新加坡仅有的两家儿科三级医院的 PIBD≤18 岁患者的病历。根据新加坡特定年龄人群数据计算 PIBD 的平均年发病率（MAI）。
PIBD 的总体 MAI 为 1.26/10 万（95%置信区间[CI] 0.56-1.96）。在第一个十年（1994-2004 年），MAI 为 0.23/10 万（95%CI 0.08-0.39）；在第二个十年（2005-2015 年），MAI 几乎增加了 10 倍，达到 2.28/10 万（95%CI 1.15-3.41）。线性回归分析显示，22 年间 MAI 显著增加（r=0.826，P<0.0001）。在 228 名患者中，61.0%为克罗恩病（CD），30.3%为溃疡性结肠炎，8.7%为 IBD 未分类，中位诊断年龄为 10.47 岁，男性居多（58.3%）；诊断时<10 岁的患者占 37.7%，17.5%为极早发性 IBD。在 CD 中，27.3%有狭窄和/或穿透性疾病，21.6%有肛周疾病。印度人比例过高，而阳性家族史罕见（1.3%）。
尽管新加坡 PIBD 并不常见，但近年来发病率急剧上升。疾病发病年龄更小，肛周和狭窄/穿透性疾病比例更高，提示疾病更具侵袭性，与西方数据不同。
