日本儿童炎症性肠病的表型特征：多中心登记研究结果
Phenotypic characteristics of pediatric inflammatory bowel disease in Japan: results from a multicenter registry.
作者信息
Arai Katsuhiro, Kunisaki Reiko, Kakuta Fumihiko, Hagiwara Shin-Ichiro, Murakoshi Takatsugu, Yanagi Tadahiro, Shimizu Toshiaki, Kato Sawako, Ishige Takashi, Aomatsu Tomoki, Inoue Mikihiro, Saito Takeshi, Iwama Itaru, Kawashima Hisashi, Kumagai Hideki, Tajiri Hitoshi, Iwata Naomi, Mochizuki Takahiro, Noguchi Atsuko, Kashiwabara Toshihiko, Shimizu Hirotaka, Suzuki Yasuo, Hirano Yuri, Fujiwara Takeo
机构信息
Division of Gastroenterology, National Center for Child Health and Development, Setagaya, Japan.
Inflammatory Bowel Disease Center, Yokohama City University Medical Center, Yokohama, Japan.
出版信息
Intest Res. 2020 Oct;18(4):412-420. doi: 10.5217/ir.2019.00130. Epub 2020 Aug 18.
BACKGROUND/AIMS: There are few published registry studies from Asia on pediatric inflammatory bowel disease (IBD). Registry network data enable comparisons among ethnic groups. This study examined the characteristics of IBD in Japanese children and compared them with those in European children.
METHODS
This was a cross-sectional multicenter registry study of newly diagnosed Japanese pediatric IBD patients. The Paris classification was used to categorize IBD features, and results were compared with published EUROKIDS data.
RESULTS
A total of 265 pediatric IBD patients were initially registered, with 22 later excluded for having incomplete demographic data. For the analysis, 91 Crohn's disease (CD), 146 ulcerative colitis (UC), and 6 IBD-unclassified cases were eligible. For age at diagnosis, 20.9% of CD, 21.9% of UC, and 83.3% of IBD-unclassified cases were diagnosed before age 10 years. For CD location, 18.7%, 13.2%, 64.8%, 47.3%, and 20.9% were classified as involving L1 (ileocecum), L2 (colon), L3 (ileocolon), L4a (esophagus/stomach/duodenum), and L4b (jejunum/proximal ileum), respectively. For UC extent, 76% were classified as E4 (pancolitis). For CD behavior, B1 (non-stricturing/non-penetrating), B2 (stricturing), B3 (penetrating), and B2B3 were seen in 83.5%, 11.0%, 3.3%, and 2.2%, respectively. A comparison between Japanese and European children showed less L2 involvement (13.2% vs. 27.3%, P< 0.01) but more L4a (47.3% vs. 29.6%, P< 0.01) and L3 (64.8% vs. 52.7%, P< 0.05) involvement in Japanese CD children. Pediatric perianal CD was more prevalent in Japanese children (34.1% vs. 9.7%, P< 0.01).
CONCLUSIONS
Upper gastrointestinal and perianal CD lesions are more common in Japanese children than in European children.
背景/目的：亚洲关于儿童炎症性肠病（IBD）的已发表注册研究较少。注册网络数据有助于不同种族群体之间的比较。本研究调查了日本儿童IBD的特征，并将其与欧洲儿童的特征进行比较。
方法
这是一项对新诊断的日本儿童IBD患者进行的横断面多中心注册研究。采用巴黎分类法对IBD特征进行分类，并将结果与已发表的欧洲儿童IBD（EUROKIDS）数据进行比较。
结果
最初共登记了265例儿童IBD患者，其中22例因人口统计学数据不完整而被排除。纳入分析的有91例克罗恩病（CD）、146例溃疡性结肠炎（UC）和6例未分类的IBD病例。诊断时的年龄方面，20.9%的CD、21.9%的UC和83.3%的未分类IBD病例在10岁前被诊断。CD病变部位方面，分别有18.7%、13.2%、64.8%、47.3%和20.9%被分类为累及L1（回盲部）、L2（结肠）、L3（回结肠）、L4a（食管/胃/十二指肠）和L4b（空肠/近端回肠）。UC病变范围方面，76%被分类为E4（全结肠炎）。CD行为方面，B1（非狭窄/非穿透性）、B2（狭窄性）、B3（穿透性）和B2B3分别占83.5%、11.0%、3.3%和2.2%。日本儿童与欧洲儿童的比较显示，日本CD儿童中L2累及较少（13.2%对27.3%，P<0.01），但L4a（47.3%对29.6%，P<0.01）和L3（64.8%对52.7%，P<0.05）累及较多。日本儿童的小儿肛周CD更为普遍（34.1%对9.7%，P<0.01）。
结论
日本儿童上消化道和肛周CD病变比欧洲儿童更常见。
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