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中国早发性克罗恩病儿科患者的特殊临床特征和结局。

Special clinical characteristics and outcomes in Chinese pediatric patients with early-onset Crohn's disease.

机构信息

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.

出版信息

J Dig Dis. 2019 Oct;20(10):539-546. doi: 10.1111/1751-2980.12803. Epub 2019 Sep 10.

Abstract

OBJECTIVE

To study the clinical and nutritional characteristics of early-onset Crohn's disease (EO-CD) in China.

METHODS

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.

RESULTS

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.

CONCLUSION

The EO-CD group had worse clinical outcomes and nutritional status than the LO-CD group.

摘要

目的

研究中国早发型克罗恩病(EO-CD)的临床和营养特征。

方法

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。

结果

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。

结论

与 LO-CD 组相比,EO-CD 组的临床结局和营养状况更差。

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