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在低发病率地区炎症性肠病的临床特征和治疗:台湾基于医院的回顾性队列研究。

Clinical features and treatment of inflammatory bowel disease in a low-incidence area: A hospital-based retrospective cohort study in Taiwan.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital.

Institute of Medicine, Chung Shan Medical University, Taichung.

出版信息

Medicine (Baltimore). 2021 Mar 12;100(10):e25090. doi: 10.1097/MD.0000000000025090.

Abstract

Inflammatory bowel disease (IBD) has emerged in the Asia-Pacific area over the past 2 decades. There is a paucity of clinical data regarding real-world experience of patients with IBD from low endemic area such as Taiwan. Therefore, the present study aimed to review the clinical features of patients with IBD form a tertiary center from Taiwan.A total of 163 patients with IBD were identified from the electronic clinical database of Changhua Christian Hospital. Demographic data of the patients and clinical features of the disease pattern were retrospectively reviewed.There was a higher proportion (62.6%) of patients diagnosed with ulcerative colitis (UC). Patients with Crohn disease (CD) and UC had male predominance. The median age of diagnosis was younger in patients with CD than in patients with UC (CD vs UC: 31 vs 40 years, P = .0423). The disease distribution of UC was as follows: E1 (15.7%), E2 (47.1%), and E3 (37.3%). The disease distribution of CD was as follows: L1 (36.1%), L2 (14.8%), L3 (42.6%), and L4 (6.5%). The majority of patients with CD had a complicated presentation with B2 (32.8%) and B3 (32.8%). Patients with CD had a higher bowel resection rate than patients with UC. Patients with CD were more likely to be treated with immunomodulator and biologics and those with UC were more likely to be treated with 5-aminosalicylic acid (5-ASA). A trend of decreased bowel resection for patients with IBD and less severe phenotype of patients with CD were observed after 2015.UC with male predominance was the predominant type of IBD in the study. Patients with CD are likely to have a complicated disease course, requiring a higher demand of biologic therapy than patients with UC.

摘要

炎症性肠病(IBD)在过去 20 年中在亚太地区出现。来自低流行地区(如台湾)的 IBD 患者的真实世界经验的临床数据很少。因此,本研究旨在回顾来自台湾一家三级中心的 IBD 患者的临床特征。

从彰化基督教医院的电子临床数据库中确定了 163 例 IBD 患者。回顾性分析患者的人口统计学数据和疾病模式的临床特征。

溃疡性结肠炎(UC)的诊断比例较高(62.6%)。克罗恩病(CD)和 UC 患者以男性为主。CD 患者的诊断中位年龄小于 UC 患者(CD 与 UC:31 岁与 40 岁,P=0.0423)。UC 的疾病分布如下:E1(15.7%)、E2(47.1%)和 E3(37.3%)。CD 的疾病分布如下:L1(36.1%)、L2(14.8%)、L3(42.6%)和 L4(6.5%)。大多数 CD 患者表现复杂,B2(32.8%)和 B3(32.8%)。CD 患者的肠切除术率高于 UC 患者。CD 患者更可能接受免疫调节剂和生物制剂治疗,而 UC 患者更可能接受 5-氨基水杨酸(5-ASA)治疗。观察到 2015 年后 IBD 患者的肠切除术减少和 CD 患者的疾病表型减轻的趋势。

研究中以男性为主的 UC 是 IBD 的主要类型。CD 患者可能具有复杂的病程,比 UC 患者更需要生物治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/53d1/7969237/506de49358bd/medi-100-e25090-g001.jpg

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