Pagenault M, Tron I, Alexandre J L, Cruchant E, Dabadie A, Chaperon J, Robaszkiewicz M, Bretagne J F
Service d'Hépato-Gastroentérologie, CHU Pontchaillou, Rennes.
Gastroenterol Clin Biol. 1997;21(6-7):483-90.
The aim of the study was to determine the incidence and the main clinical data of inflammatory bowel disease in Brittany.
According to EPIMAD registry's methodology, private and public gastroenterologists (n = 139) of Brittany (2836418 inhabitants) referred all patients consulting for the first time, in 1994 and 1995 with clinical symptoms compatible with inflammatory bowel disease. An interviewer practitioner completed at the gastroenterologist's consulting room a standard questionnaire for each patient. Each case was reviewed separately by four experts to assign a diagnosis of definite, probable, possible Crohn's disease, ulcerative colitis, unclassifiable chronic colitis, or acute colitis (onset of symptoms < 6 weeks).
657 cases were recorded: 205 Crohn's disease (31%), 165 ulcerative colitis (25%) including 75 ulcerative proctitis (46%), 42 unclassifiable chronic colitis (7%), 245 acute colitis (37%). The crude mean annual incidence (per 10(5) inhabitants) based on definite and probable cases only was 2.8 for Crohn's disease and 2.9 for ulcerative colitis. The female/male ratio was 0.9 for Crohn's disease and 0.5 for ulcerative colitis. The median age at time of diagnosis was 27 for Crohn's disease and 36 for ulcerative colitis. The median time between onset of symptoms and diagnosis was equal to 3 months for Crohn's disease and ulcerative colitis.
In Brittany the observed incidence of ulcerative colitis is similar to that of Crohn's disease and close to that observed in northern France. The incidence of Crohn's disease is lower. However, the real incidence of inflammatory bowel disease is currently underestimated due to the large number of acute colitis requiring a follow up and the cases of Crohn's disease classified as possible not taken into account.
本研究旨在确定布列塔尼地区炎症性肠病的发病率及主要临床数据。
根据EPIMAD登记处的方法,布列塔尼地区(2836418名居民)的私立和公立胃肠病学家(共139人)将1994年和1995年首次因符合炎症性肠病临床症状前来咨询的所有患者进行了转诊。一名访视医生在胃肠病学家的诊室为每位患者填写了一份标准问卷。每个病例由四位专家分别进行审查,以确定诊断为明确、可能、疑似克罗恩病、溃疡性结肠炎、无法分类的慢性结肠炎或急性结肠炎(症状出现时间<6周)。
共记录657例病例:205例克罗恩病(31%),165例溃疡性结肠炎(25%),其中包括75例溃疡性直肠炎(46%),42例无法分类的慢性结肠炎(7%),245例急性结肠炎(37%)。仅基于明确和可能病例计算的粗年均发病率(每10万居民),克罗恩病为2.8,溃疡性结肠炎为2.9。克罗恩病的女性/男性比例为0.9,溃疡性结肠炎为0.5。克罗恩病诊断时的中位年龄为27岁,溃疡性结肠炎为36岁。克罗恩病和溃疡性结肠炎从症状出现到诊断的中位时间均为3个月。
在布列塔尼地区,观察到的溃疡性结肠炎发病率与克罗恩病相似,且与法国北部观察到的发病率相近。克罗恩病的发病率较低。然而,由于大量需要随访的急性结肠炎病例以及未计入可能的克罗恩病病例,目前炎症性肠病的实际发病率被低估。