Chou Jen-Wei, Lai Hsiang-Chun, Chang Chia-Hsi, Cheng Ken-Sheng, Feng Chun-Lung, Chen Tsung-Wei
School of Medicine, China Medical University, Taichung, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan.
Gastroenterol Res Pract. 2019 Jun 13;2019:4175923. doi: 10.1155/2019/4175923. eCollection 2019.
The incidence and prevalence of inflammatory bowel disease (IBD) are low but increasing in Taiwan. We aimed to investigate the epidemiology and clinical outcomes of IBD in central Taiwan. We retrospectively analyzed patients with IBD diagnosed at our hospital between January 2000 and September 2018. The diagnostic criteria were based on endoscopic and pathologic findings. Clinical characteristics, treatment regimens, and treatment outcomes were analyzed. A total of 190 patients with IBD were enrolled (80 with Crohn's disease (CD) and 110 with ulcerative colitis (UC)). The mean age at diagnosis was 38.4 years (CD: 36 years, UC: 40 years). Male patients accounted for the majority of patients (71.1%). The male-to-female ratio was 3 : 1 for CD and 2.1 : 1 for UC. Current and ever smokers accounted for 30.5% of all patients. Only 4.2% of patients had a family history of IBD. Extraintestinal manifestations (EIMs) were reported in 7.9%, and colorectal cancers (CRCs) were reported in 2.1% of all patients. In patients with CD, the ileal type was the most common disease phenotype (57.5%), and the stricturing type was the most common disease behavior (60.0%). In patients with UC, left-sided colitis was the predominant disease extent (42.7%). The seroprevalence of hepatitis B virus (HBV) was 13.3%. The incidence of perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) in patients with UC was 22%. 5-Aminosalicylic acids were the preferred treatment for UC, whereas corticosteroids, immunomodulators, and biologic agents were preferred for CD. In patients with CD, the bowel resection rate was 38.8%, and the incidence of hip avascular necrosis was 3.8%. In Taiwan, patients with IBD showed a male predominance, lack of familial clustering, a higher prevalence of HBV infection, and a lower prevalence of p-ANCA, EIMs, and CRC. Moreover, a higher incidence of the ileal type with poor outcomes of CD and left-sided predominance in UC were found.
炎症性肠病（IBD）在台湾的发病率和患病率较低，但呈上升趋势。我们旨在调查台湾中部IBD的流行病学和临床结局。我们回顾性分析了2000年1月至2018年9月期间在我院诊断为IBD的患者。诊断标准基于内镜和病理检查结果。分析了临床特征、治疗方案和治疗结局。共纳入190例IBD患者（80例克罗恩病（CD）和110例溃疡性结肠炎（UC））。诊断时的平均年龄为38.4岁（CD：36岁，UC：40岁）。男性患者占大多数（71.1%）。CD的男女比例为3∶1，UC为2.1∶1。当前吸烟者和既往吸烟者占所有患者的30.5%。仅有4.2%的患者有IBD家族史。7.9%的患者有肠外表现（EIMs），2.1%的患者有结直肠癌（CRC）。在CD患者中，回肠型是最常见的疾病表型（57.5%），狭窄型是最常见的疾病行为（60.0%）。在UC患者中，左侧结肠炎是主要的疾病范围（42.7%）。乙肝病毒（HBV）血清阳性率为13.3%。UC患者中核周抗中性粒细胞胞浆抗体（p-ANCA）的发生率为22%。5-氨基水杨酸是UC的首选治疗药物，而皮质类固醇、免疫调节剂和生物制剂是CD的首选治疗药物。在CD患者中，肠切除率为38.8%，髋部缺血性坏死的发生率为3.8%。在台湾，IBD患者以男性为主，缺乏家族聚集性，HBV感染患病率较高，p-ANCA、EIMs和CRC的患病率较低。此外，还发现CD回肠型发病率较高且预后较差，UC以左侧为主。
