肛周克罗恩病的发病和疾病进程：1997-2015 年丹麦全国队列研究。

The Incidence and Disease Course of Perianal Crohn's Disease: A Danish Nationwide Cohort Study, 1997-2015.

机构信息

Medical Faculty, University of Copenhagen, Copenhagen, Denmark.

Department of Gastroenterology, Herlev Gentofte University Hospital, Herlev, Denmark.

出版信息

J Crohns Colitis. 2021 Jan 13;15(1):5-13. doi: 10.1093/ecco-jcc/jjaa118.

DOI:10.1093/ecco-jcc/jjaa118

PMID:32582937

Abstract

BACKGROUND AND AIMS

Perianal Crohn's disease [CD] places a considerable burden on patients' quality of life and is complex to treat. Despite its impact and high frequency, few studies have investigated the incidence and disease course of perianal CD. The aim of this study was to assess the incidence and disease course of perianal CD in adult patients throughout a 19-year period.

METHODS

The cohort comprised all individuals aged 18 years or older who were diagnosed with CD in Denmark between January 1, 1997, and December 31, 2015, according to the National Patient Registry [NPR].

RESULTS

A total of 1812 [19%] out of 9739 patients with CD were found to have perianal CD. Perianal fistulas were the most common manifestation, accounting for 943 [52%] cases. The incidence of perianal CD remained stable over time. Patients with perianal CD were found to have an increased risk of undergoing major abdominal surgery compared with patients without perianal CD (hazard ratio: 1.51, 95% confidence interval [CI]: 1.40 to 1.64, p <0.001) in a multivariate Cox regression analysis. The incidence rate ratios of anal and rectal cancer in perianal CD patients were 11.45 [95% CI: 4.70 to 27.91, p <0.001] and 2.29 [95% CI: 1.25 to 4.20, p = 0.006], respectively, as compared with non-IBD matched controls.

CONCLUSIONS

In this nationwide study, 19% of CD patients developed perianal disease. Patients with perianal CD were at increased risk of undergoing major surgery compared with non-perianal CD patients. The risk of anal and rectal cancer was increased in patients with perianal CD compared with non-IBD matched controls.

PODCAST

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摘要

背景与目的

肛周克罗恩病（CD）对患者的生活质量造成了相当大的负担，且治疗复杂。尽管肛周 CD 影响大且发病率高，但很少有研究调查肛周 CD 的发病率和疾病进程。本研究旨在评估 19 年内丹麦成年患者肛周 CD 的发病率和疾病进程。

方法

该队列纳入了所有于 1997 年 1 月 1 日至 2015 年 12 月 31 日期间在丹麦国家患者登记处（NPR）诊断为 CD 的年龄在 18 岁或以上的患者。

结果

在 9739 例 CD 患者中，共有 1812 例（19%）被发现患有肛周 CD。肛周瘘管是最常见的表现，占 943 例（52%）。肛周 CD 的发病率随时间保持稳定。多变量 Cox 回归分析显示，与无肛周 CD 的患者相比，有肛周 CD 的患者接受重大腹部手术的风险增加（风险比：1.51，95%置信区间 [CI]：1.40 至 1.64，p<0.001）。在肛周 CD 患者中，肛门和直肠癌症的发病率比值分别为 11.45（95%CI：4.70 至 27.91，p<0.001）和 2.29（95%CI：1.25 至 4.20，p=0.006），与非 IBD 匹配对照相比。