Myren J, Bouchier I A, Watkinson G, Softley A, Clamp S E, de Dombal F T
Scand J Gastroenterol Suppl. 1984;95:1-27.
This presentation describes the progress during 1978-1982 of the O.M.G.E. Multinational Survey of patients with inflammatory bowel disease. After a brief description of the study design and protocol, and review of results up to 1978, the status of the survey in 1982 is presented. In all, 35 centres contributed 2,657 cases at that time; data collection being meticulous via previously designed proformata. Diagnostic criteria are next discussed. Little change between 1978 and 1982 is noted, with wide variation in the UC/CD ratio for individual centres, but continuing evidence of a congruence of diagnostic thought, now codified into a simple (and recommended) O.M.G.E. Scoring System. Patients seen prior to 1978 were reviewed in 1982. Where attempted, a follow-up of over 90% was achieved, usually more than four years after the original presentation. Interesting data resulted. The stability of diagnosis was high, only 3.4% of patient diagnoses changing between 1978 and 1982. The mortality of Crohn's disease patients, usually unrelated to surgery, was higher than that of ulcerative colitis patents, and the cancer risk identical in the two groups. Most patients were well at review; but--though asymptomatic--were usually on prophylactice therapy, most commonly with salazopyrine. Finally, problems in assessing severity and activity of disease are discussed, and joint studies between O.M.G.W. and the newly formed International Organisation for the Study of I.B.D. described. As regards Crohn's disease, several 'indices of activity' already exist; when tested on a set of 200 O.M.G.E. patients, indices did not correlate well with each other, or with patient prognosis. Further studies are suggested during 1982-1986.
本报告介绍了1978 - 1982年间O.M.G.E.炎症性肠病患者多国调查的进展情况。在简要描述研究设计和方案,并回顾了截至1978年的结果之后,介绍了1982年的调查状况。当时共有35个中心提供了2657例病例;数据收集通过预先设计的表格进行,十分细致。接下来讨论了诊断标准。1978年至1982年间变化不大,各中心的溃疡性结肠炎/克罗恩病比例差异很大,但仍有证据表明诊断思路具有一致性,现在已编纂成一个简单的(并推荐使用的)O.M.G.E.评分系统。1982年对1978年之前就诊的患者进行了复查。在可行的情况下,随访率超过90%,通常是在初次就诊四年多之后。得出了一些有趣的数据。诊断的稳定性很高,1978年至1982年间只有3.4%的患者诊断发生了变化。克罗恩病患者的死亡率通常与手术无关,高于溃疡性结肠炎患者,且两组的癌症风险相同。大多数患者复查时情况良好;但尽管无症状,通常仍在接受预防性治疗,最常用的药物是柳氮磺胺吡啶。最后,讨论了评估疾病严重程度和活动度方面的问题,并描述了O.M.G.W.与新成立的国际炎症性肠病研究组织之间的联合研究。关于克罗恩病,已经有几个“活动指数”;在一组200例O.M.G.E.患者身上进行测试时,这些指数彼此之间以及与患者预后的相关性都不太好。建议在1982 - 1986年间进行进一步研究。