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