Lashner B A
Cleveland Clinic Foundation, Ohio, USA.
Gastroenterol Clin North Am. 1995 Sep;24(3):467-74.
The search for the cause of inflammatory bowel disease through epidemiologic investigation is centered on documenting disease variability and determining the reason for such variability. An examination of the person, place, and time variability of inflammatory bowel disease can provide important clues to disease pathogenesis. Although there is a great deal of variability in the epidemiology of inflammatory bowel disease among populations, there is little difference in these populations between Crohn's disease and ulcerative colitis with regard to person, place, or time variability. With notable exceptions, such as cigarette smoking, the epidemiologic variability of ulcerative colitis and Crohn's disease is remarkably similar. Such similarities are unlikely to be coincidences. The possible implications from this observation are that ulcerative colitis and Crohn's disease are actually different expressions of the same disease, expressions determined by such factors as cigarette smoking, or that two separate diseases share a near complete set of risk factors. Whichever theory is correct, environmental risk factors, which are preventable, are certain to be involved in causative mechanisms.
通过流行病学调查寻找炎症性肠病的病因，重点在于记录疾病的变异性并确定这种变异性的原因。对炎症性肠病的人、地点和时间变异性进行研究，可以为疾病的发病机制提供重要线索。尽管不同人群中炎症性肠病的流行病学存在很大差异，但就人、地点或时间变异性而言，克罗恩病和溃疡性结肠炎在这些人群中差异不大。除了吸烟等明显的例外情况，溃疡性结肠炎和克罗恩病的流行病学变异性非常相似。这种相似性不太可能是巧合。这一观察结果可能意味着，溃疡性结肠炎和克罗恩病实际上是同一疾病的不同表现形式，这些表现形式由吸烟等因素决定，或者这两种不同的疾病共享几乎一整套风险因素。无论哪种理论正确，可预防的环境风险因素肯定参与了致病机制。
