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发病年龄对肠型贝赫切特病患者长期预后的影响。

Impact of age at diagnosis on long-term prognosis in patients with intestinal Behçet's disease.

机构信息

Department of Health Promotion Medicine, Ewha Womans University Seoul Hospital, Seoul, South Korea.

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea.

出版信息

J Gastroenterol Hepatol. 2024 Mar;39(3):519-526. doi: 10.1111/jgh.16449. Epub 2023 Dec 27.

Abstract

BACKGROUND AND AIM

Although age at disease onset is considered to be a significant factor in the prognosis of Crohn's disease, little is known about its influence on the long-term prognosis of those with intestinal Behçet's disease (BD). This study aimed to evaluate the long-term clinical outcomes of patients with intestinal BD according to age of disease onset.

METHODS

Patients diagnosed with intestinal BD at < 18, 18-60, and > 60 years of age were classified into early-onset, adult-onset, and late-onset groups, respectively. The influence of disease onset time on clinical prognosis, including specific medical requirements, BD-related intestinal surgery, hospitalization, and emergency room visits, was compared using the log-rank test in a large cohort of patients with intestinal BD.

RESULTS

Among 780 patients, 21 (2.7%), 672 (86.2%), and 87 (11.1%) comprised the early-onset, adult-onset, and late-onset groups, respectively. Patients in the early-onset group were more likely to require immunosuppressants than those in the adult-onset group (P = 0.048). Nine (42.9%), 158 (23.5%), and 18 (20.7%) patients in the early-onset, adult-onset, and late-onset groups, respectively, underwent intestinal resection. The early-onset group exhibited a higher risk for intestinal resection than the late-onset (P = 0.043) and adult-onset (P = 0.030) groups. The late-onset group exhibited a higher risk for BD-related hospitalization than the adult-onset group (P = 0.023).

CONCLUSIONS

Age at diagnosis affected the clinical course of intestinal BD, including intestinal surgery, hospitalization, and specific medical requirements. Different treatment strategies should be established according to age at diagnosis.

摘要

背景与目的

虽然发病年龄被认为是克罗恩病预后的重要因素,但对于肠型贝赫切特病(BD)患者的长期预后,其影响知之甚少。本研究旨在评估不同发病年龄的肠型 BD 患者的长期临床结局。

方法

将诊断为肠型 BD 的患者分为<18 岁、18-60 岁和>60 岁的早发型、成人型和晚发型,分别归入三组。采用对数秩检验比较三组患者的疾病发病时间对临床预后的影响,包括特定医疗需求、BD 相关肠内手术、住院和急诊就诊情况。

结果

780 例患者中,21 例(2.7%)、672 例(86.2%)和 87 例(11.1%)分别归入早发型、成人型和晚发型组。早发型组患者比成人型组更需要使用免疫抑制剂(P=0.048)。三组中分别有 9 例(42.9%)、158 例(23.5%)和 18 例(20.7%)接受肠切除术。早发型组比晚发型组(P=0.043)和成人型组(P=0.030)的肠切除术风险更高。晚发型组比成人型组的 BD 相关住院风险更高(P=0.023)。

结论

发病年龄影响肠型 BD 的临床病程,包括肠内手术、住院和特定医疗需求。应根据发病年龄制定不同的治疗策略。

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