Gilat T, Hacohen D, Lilos P, Langman M J
Ichilov Hospital, Tel Aviv, Israel.
Scand J Gastroenterol. 1987 Oct;22(8):1009-24. doi: 10.3109/00365528708991950.
This international case control study was conducted in 14 centers in 9 countries to investigate factors in childhood which may have a bearing on the etiology or pathogenesis of ulcerative colitis (UC) and Crohn's disease (CD). 197 patients with UC and 302 with CD (499 with inflammatory bowel disease (IBD] whose disease started before age 20 years and whose age at time of study was less than 25 years were investigated, with two age- and sex-matched controls for each patient. All subjects were studied with uniform questionnaires. Eczema was found significantly more frequently in patients with CD (p less than 0.005) and in their fathers (p less than 0.025), mothers (p less than 0.002), and siblings (p less than 0.01) as compared with their respective controls. IBD was significantly more frequent in parents, siblings, cousins, grandparents, and uncles of patients than in their respective controls. The fathers of patients with UC had significantly more major gastrointestinal and cardiovascular diseases at the time of the patient's birth than the fathers of controls. In North America mothers of patients with UC and CD took vitamin, mineral, and iron preparations during pregnancy significantly less frequently than mothers of controls. Patients with CD and UC consumed a lower residue diet than controls. Recurrent respiratory infections were more frequent in patients with UC and CD (p less than 0.001); it is uncertain whether this preceded disease. Hospitalization for respiratory diseases was more frequent in patients than controls, and the use of antibiotics more frequent in patients with CD. Smallpox vaccination was less frequent (p less than 0.05) in patients with CD, and chickenpox infection was less common in patients with UC (p less than 0.01). No significant differences were found between patients and controls in relation to various human and non-human contacts during childhood. Number of siblings, being an only child, and birth order did not differ markedly between patients and controls, and we could not confirm the 'sheltered child' hypothesis in IBD. The parents of controls were slightly better educated and their social class tended to be higher than those of parents of patients. There were significant associations between some of the main factors investigated in this study. No significant differences were found between patients and controls in the frequency of breast feeding, cereal consumption, sugar added to milk in infancy, gastroenteritis in childhood, major stressful life events, and many other factors.(ABSTRACT TRUNCATED AT 400 WORDS)
这项国际病例对照研究在9个国家的14个中心开展，旨在调查儿童期可能与溃疡性结肠炎（UC）和克罗恩病（CD）的病因或发病机制相关的因素。研究了197例UC患者和302例CD患者（共499例炎症性肠病（IBD）患者，其疾病始于20岁之前且研究时年龄小于25岁），为每位患者匹配两名年龄和性别相符的对照。所有受试者均通过统一问卷进行研究。与各自的对照组相比，发现湿疹在CD患者中更常见（p<0.005），在其父亲（p<0.025）、母亲（p<0.002）和兄弟姐妹中也更常见（p<0.01）。IBD在患者的父母、兄弟姐妹、堂表亲、祖父母和叔伯中比在各自的对照组中更常见。UC患者的父亲在患者出生时患主要胃肠道和心血管疾病的比例显著高于对照组的父亲。在北美，UC和CD患者的母亲在孕期服用维生素、矿物质和铁制剂的频率显著低于对照组的母亲。CD和UC患者摄入的食物残渣比对照组少。UC和CD患者反复发生呼吸道感染的情况更常见（p<0.001）；尚不确定这是否先于疾病发生。患者因呼吸道疾病住院的频率高于对照组，CD患者使用抗生素的频率更高。CD患者接种天花疫苗的频率较低（p<0.05），UC患者感染水痘的情况较少见（p<0.01）。在童年期与各种人和非人接触方面，患者与对照组之间未发现显著差异。患者与对照组在兄弟姐妹数量、是否为独生子女及出生顺序方面无明显差异，我们无法证实IBD中的“受保护儿童”假说。对照组的父母受教育程度略高，其社会阶层往往高于患者的父母。本研究中调查的一些主要因素之间存在显著关联。在母乳喂养频率、谷物摄入量、婴儿期牛奶中添加糖的量、儿童期胃肠炎、重大生活应激事件及许多其他因素方面，患者与对照组之间未发现显著差异。（摘要截选至400词）
