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巴基斯坦克罗恩病诊断相关因素评估:面对发病率上升趋势的研究

Evaluation of Factors Contributing to Diagnosis of Crohn's Disease in the Face of Increasing Trend in Pakistan.

作者信息

Akhtar Tayyab Saeed, Ashraf Bilal, Zahid Kanza, Abbas Sameen, Sana Anosh, Khan Abdul Rauf, Ijaz Faiqa, Riaz Faisal

机构信息

Center for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi, Pakistan.

Rawalpindi Medical University, Rawalpindi, Pakistan.

出版信息

Crohns Colitis 360. 2024 Mar 22;6(1):otae015. doi: 10.1093/crocol/otae015. eCollection 2024 Jan.

Abstract

BACKGROUND

Crohn's disease (CD) is characterized by granulomatous inflammation of the digestive tract. Diagnosing CD involves assessing clinical symptoms, radiological and endoscopic findings, and histopathological evidence. Although previously considered a disease in developed countries, CD is increasing in developing nations, but challenges exist in diagnosing CD promptly. This study aims to report diagnostic parameters for early and correct CD diagnosis in Pakistan.

METHODOLOGY

A retrospective analysis from June 2016 to August 2023 of 22 CD patients was done, by data from medical records, questionnaires completed at diagnosis, and telephonic interviews. Baseline demographic and clinical characteristics were assessed, and patients were categorized using the Montreal classification.

RESULTS

CD was diagnosed in 22 patients, with a 1:1 male-to-female ratio with a mean age of 33 years (range 15-55 years). Symptoms at presentation included abdominal pain (95.5%), watery diarrhea (86.4%), fever (31.8%), rectal bleeding (54.5%), and weight loss (81.8%) with 68% having symptoms for over 12 months before diagnosis. Disease characteristics were diverse, with various patterns of involvement and histopathological findings.

CONCLUSIONS

In resource-limited countries like Pakistan, the timely diagnosis of CD presents a significant healthcare challenge. Therefore, it is necessary to tackle these complex problems by enhancing diagnostic capabilities, raising medical awareness, and improving access to healthcare resources.

摘要

背景

克罗恩病(CD)的特征是消化道的肉芽肿性炎症。诊断CD需要评估临床症状、放射学和内镜检查结果以及组织病理学证据。尽管CD以前被认为是发达国家的疾病,但在发展中国家其发病率正在上升,不过在及时诊断CD方面仍存在挑战。本研究旨在报告巴基斯坦早期正确诊断CD的诊断参数。

方法

对2016年6月至2023年8月期间的22例CD患者进行回顾性分析,数据来自病历、诊断时填写的问卷以及电话访谈。评估基线人口统计学和临床特征,并使用蒙特利尔分类法对患者进行分类。

结果

确诊22例CD患者,男女比例为1:1,平均年龄33岁(范围15 - 55岁)。就诊时的症状包括腹痛(95.5%)、水样腹泻(86.4%)、发热(31.8%)、直肠出血(54.5%)和体重减轻(81.8%),68%的患者在诊断前症状持续超过12个月。疾病特征多样,有各种受累模式和组织病理学表现。

结论

在像巴基斯坦这样资源有限的国家,及时诊断CD是一项重大的医疗挑战。因此,有必要通过提高诊断能力、提升医疗意识和改善医疗资源可及性来解决这些复杂问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ffae/10959480/b1d2638a444e/otae015_fig3.jpg

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