Swansea University Medical School, Swansea University, Swansea, UK.
Department of Paediatric Gastroenterology, Queensland Children's Hospital, Brisbane, Australia.
United European Gastroenterol J. 2024 Feb;12(1):89-102. doi: 10.1002/ueg2.12465. Epub 2023 Nov 3.
Several studies have reported large increases in the incidence of eosinophilic oesophagitis (EoE) in the last 20 years. We aimed to systematically review the incidence and prevalence of EoE, focused on all European countries.
Systematic review and meta-analysis up to 31 December 2022, based on PubMed, CINAHL and extensive hand searching of reference lists. Twenty-five eligible studies were identified and included.
For both adults and children, the highest EoE incidence and prevalence have been reported from regional studies in Spain. EoE incidence for both adults and children was significantly lower (p < 0.001) in nationwide studies (meta-analysis = 3.64 per 100,000 person-years overall) compared with regional or centre-based studies (7.16). EoE incidence and prevalence were significantly higher (p < 0.001) in adults than children. All studies that reported on longitudinal trends in EoE incidence showed increases over time, more markedly during more recent years. Larger increases in incidence tend to refer to regional rather than nationwide studies; from Spain, Switzerland and Denmark, both for paediatric and adult age groups. Increases in EoE incidence 100,000 person-years were larger than for incidence per number of diagnostic endoscopies. The most frequently reported co-morbidities in adults were rhinitis, followed by asthma, food allergy and gastroesophageal reflux disease, and in children, erosive oesophagitis, asthma, food allergy and rhinitis.
The incidence of EoE has increased in Europe over the last 30 years, exceeding increases in the volume of oesophago-gastro-duodenoscopies performed. The patchy and low incidence and prevalence of EoE generally in Europe and compared with North America, may reflect a lack of clinical awareness and research focus rather than a genuinely low incidence of EoE. A co-ordinated Europe-wide study that uses standardised methodology is urgently needed to provide a comprehensive picture of EoE incidence and prevalence across Europe.
在过去的 20 年里，几项研究报告称嗜酸细胞性食管炎 (EoE) 的发病率大幅上升。我们旨在系统地回顾 EoE 的发病率和流行率，重点关注所有欧洲国家。
基于 PubMed、CINAHL 和广泛的参考文献手工搜索，进行系统回顾和荟萃分析，截至 2022 年 12 月 31 日。确定并纳入了 25 项符合条件的研究。
在西班牙的区域性研究中，成人和儿童的 EoE 发病率和患病率最高。与全国性研究相比，成人和儿童的 EoE 发病率（p<0.001；荟萃分析=总体每 10 万人年 3.64 例）显著较低（meta-analysis = 总体每 10 万人年 3.64 例），而区域性或中心性研究则较高（7.16）。EoE 的发病率和患病率在成人中显著高于儿童。所有报告 EoE 发病率纵向趋势的研究均显示发病率随时间增加，近年来更为显著。发病率的增加趋势更大程度上与区域性研究而非全国性研究有关；来自西班牙、瑞士和丹麦，涵盖儿童和成年年龄组。每 10 万人年 EoE 发病率的增加大于每例诊断性内镜检查的发病率增加。在成年人中，最常报告的合并症是鼻炎，其次是哮喘、食物过敏和胃食管反流病，而在儿童中，是糜烂性食管炎、哮喘、食物过敏和鼻炎。
在过去的 30 年里，欧洲的 EoE 发病率有所增加，超过了食管胃十二指肠镜检查数量的增加。欧洲普遍存在 EoE 的发病率低且分布不均，与北美相比，这可能反映了临床意识和研究重点的缺乏，而不是 EoE 的真正发病率低。迫切需要一项协调一致的全欧洲研究，使用标准化方法，全面了解欧洲各地 EoE 的发病率和流行率。
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