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韩国儿童克罗恩病与溃疡性结肠炎诊断时的比较:一项基于多中心登记处的初始队列研究结果。

Comparison between Pediatric Crohn's Disease and Ulcerative Colitis at Diagnosis in Korea: Results from a Multicenter, Registry-Based, Inception Cohort Study.

机构信息

Department of Pediatrics, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Department of Pediatrics, School of Medicine, Kyungpook National University, Daegu, Korea.

出版信息

Gut Liver. 2022 Nov 15;16(6):921-929. doi: 10.5009/gnl210488. Epub 2022 Sep 5.

Abstract

BACKGROUND/AIMS: We aimed to compare the differences in pediatric Crohn's disease (CD) and ulcerative colitis (UC) at diagnosis in Korea.

METHODS

This was a multicenter, registry-based, inception cohort study conducted at five centers in Korea between 2013 and 2017. Baseline demographics, clinical characteristics, and results from laboratory, endoscopic, radiologic examinations were compared between pediatric CD and UC patients who were <19 years old at diagnosis.

RESULTS

A total 307 patients were included (227 CD [73.9%] and 80 UC [26.1%]). The male to female ratio was 2.49:1 for CD, and 1.49:1 for UC (p=0.019). Median age at diagnosis was 14.4 years (interquartile range, 12.4 to 16.2) for CD, and 14.4 years (interquartile range, 11.7 to 16.5) for UC (p=0.962). Hematochezia was the only dominant symptom in UC patients compared to CD patients (86.2% vs 30.8%, p<0.001). White blood cell counts, platelet counts, erythrocyte sedimentation rate, and C-reactive protein levels were significantly higher, and serum albumin level was significantly lower in CD patients than in UC patient. Anti- was positive in 44.5% and 16.2% of CD and UC patients, respectively (p<0.001), and antineutrophil cytoplasmic antibody was positive in 15.0% and 58.8% of CD and UC patients, respectively (p<0.001). Terminal ileal involvement was prominent in CD, while rectal involvement was more prominent in UC. Small bowel involvement and perianal perforating diseases were also more prominent in CD.

CONCLUSIONS

This is the first a multicenter study in Korea to compare the differences between pediatric CD and UC at diagnosis in Korea. A large-scale, national study is expected to better clarify these findings in the future.

摘要

背景/目的:本研究旨在比较韩国儿童克罗恩病(CD)和溃疡性结肠炎(UC)在诊断时的差异。

方法

这是一项在韩国五家中心进行的多中心、基于注册、发病队列研究。比较了 2013 年至 2017 年间诊断为<19 岁的儿童 CD 和 UC 患者的基线人口统计学、临床特征以及实验室、内镜和影像学检查结果。

结果

共纳入 307 例患者(227 例 CD[73.9%]和 80 例 UC[26.1%])。CD 患者的男女比例为 2.49:1,UC 患者为 1.49:1(p=0.019)。CD 患者的中位诊断年龄为 14.4 岁(四分位距,12.4-16.2),UC 患者为 14.4 岁(四分位距,11.7-16.5)(p=0.962)。与 CD 患者相比,UC 患者仅出现血便(86.2% vs 30.8%,p<0.001)这一主要症状。CD 患者的白细胞计数、血小板计数、红细胞沉降率和 C 反应蛋白水平显著升高,血清白蛋白水平显著降低。CD 和 UC 患者的抗中性粒细胞胞浆抗体阳性率分别为 44.5%和 16.2%(p<0.001),抗核抗体阳性率分别为 15.0%和 58.8%(p<0.001)。回肠末端受累在 CD 中更为突出,而直肠受累在 UC 中更为突出。CD 中小肠受累和肛周穿孔性疾病也更为突出。

结论

这是韩国第一项比较韩国儿童 CD 和 UC 在诊断时差异的多中心研究。预计未来一项大规模的全国性研究将更好地阐明这些发现。

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