Department of Gastroenterology, Pediatric Inflammatory Bowel Disease Research Center, Children's Hospital of Fudan University, Shanghai, China.
Medical Statistics Department, Children's Hospital of Fudan University, Shanghai, China.
J Dig Dis. 2019 Oct;20(10):539-546. doi: 10.1111/1751-2980.12803. Epub 2019 Sep 10.
To study the clinical and nutritional characteristics of early-onset Crohn's disease (EO-CD) in China.
Patients were defined as having EO-CD (age at diagnosis <10 y) or late-onset Crohn's disease (LO-CD; age at diagnosis of 10-17 y). Their characteristics, clinical, and nutritional data were collected at baseline and at each follow-up visit. Statistical analyses were used to compare differences in both groups.
From July 1993 to February 2017, of the 137 children enrolled, 68 (49.6%) had EO-CD and 69 (50.4%) had LO-CD. More patients with EO-CD than those with LO-CD presented with diarrhea, hematochezia, growth delay, anemia and skin disease, and had higher pediatric Crohn's disease activity index scores at diagnosis (all P < 0.05). Fewer patients with EO-CD achieved their first remission (42.6% vs 76.8%, P < 0.0001) during follow-up. Patients with EO-CD required a longer treatment time to reach remission (P = 0.0049) and had a higher mortality rate (P = 0.0133), as well as lower height and weight percentiles (P = 0.0200 and 0.0288, respectively), hemoglobin (P = 0.0185) and albumin levels (P = 0.0002), zinc (P = 0.0024) and iron (P = 0.0110) concentrations in blood at diagnosis.
The EO-CD group had worse clinical outcomes and nutritional status than the LO-CD group.
研究中国早发型克罗恩病(EO-CD)的临床和营养特征。
将患者定义为早发型 CD(诊断时年龄<10 岁)或晚发型 CD(诊断时年龄为 10-17 岁)。在基线和每次随访时收集他们的特征、临床和营养数据。使用统计分析比较两组之间的差异。
1993 年 7 月至 2017 年 2 月期间,纳入的 137 名患儿中,68 名(49.6%)为 EO-CD,69 名(50.4%)为 LO-CD。与 LO-CD 患儿相比,EO-CD 患儿腹泻、血便、生长迟缓、贫血和皮肤病更多,诊断时小儿克罗恩病活动指数评分更高(均 P<0.05)。随访期间,EO-CD 患儿首次缓解率(42.6%比 76.8%,P<0.0001)更低。EO-CD 患儿达到缓解的治疗时间更长(P=0.0049),死亡率更高(P=0.0133),身高和体重百分位数更低(P=0.0200 和 P=0.0288),血红蛋白(P=0.0185)和白蛋白水平(P=0.0002),以及血液中锌(P=0.0024)和铁(P=0.0110)浓度更低。
与 LO-CD 组相比,EO-CD 组的临床结局和营养状况更差。