Flamenbaum M, Zénut M, Aublet-Cuvelier B, Larpent J L, Fabre P, Abergel A, Dapoigny M, Bommelaer G
Service d'Hépato-Gastroentérologie, Centre Hospitalier Général, Vichy.
Gastroenterol Clin Biol. 1997;21(6-7):491-6.
The aim of this prospective epidemiological study was to investigate the incidence of Inflammatory Bowel Disease in the Puy-de-Dôme county using the same methodology as EPIMAD's registry.
From 01/01/93 to 31/12/94, each gastroenterologist (n = 22) collected patients consulting for the first time with clinical symptoms compatible with inflammatory bowel disease. Data were reported on a questionnaire by an interviewer practitioner. The final diagnosis of Crohn's disease and ulcerative colitis was made in a blind manner by two expert gastroenterologists and recorded according to the Calkin's criteria as definite, probable, or possible diagnosis, or unclassifiable chronic colitis or acute colitis.
167 new cases were identified: 112 (67.1%) inflammatory bowel disease for the combined group of definite and probable cases with 79 Crohn's disease (70.5%), 29 ulcerative colitis (25.9%) of which 11 ulcerative proctitis (37.9%), 4 unclassifiable chronic colitis (3.6%) and 55 acute colitis (32.9%). The crude and age-adjusted incidence (per 10(5)/year) was respectively 6.6 and 5.7 for Crohn's disease and 2.4 and 1.9 for ulcerative colitis. The highest age-specific incidence rate for Crohn's disease was between 40-49 years (14.1) and for ulcerative colitis between 80-89 years (6.8). The female/male ratio was 0.8 for Crohn's disease and 1.1 for ulcerative colitis. The median age at the time of diagnosis was 42.6 years for Crohn's disease and 35.3 years for ulcerative colitis.
These preliminary findings revealed a high incidence of Crohn's disease and low of ulcerative colitis in this county. However, these results must be managed carefully because these data were recorded only on two years and the inflammatory bowel disease classified possible and acute colitis require a follow-up.
本前瞻性流行病学研究的目的是采用与EPIMAD登记处相同的方法,调查多姆山省炎性肠病的发病率。
从1993年1月1日至1994年12月31日,每位胃肠病学家(共22位)收集首次因与炎性肠病相符的临床症状前来就诊的患者。数据由访视医生通过问卷报告。克罗恩病和溃疡性结肠炎的最终诊断由两名专家胃肠病学家以盲法做出,并根据卡尔金标准记录为确诊、可能或疑似诊断,或无法分类的慢性结肠炎或急性结肠炎。
共识别出167例新病例:确诊和疑似病例合并组中有112例(67.1%)为炎性肠病,其中79例为克罗恩病(70.5%),29例为溃疡性结肠炎(25.9%),其中11例为溃疡性直肠炎(37.9%),4例为无法分类的慢性结肠炎(3.6%),55例为急性结肠炎(32.9%)。克罗恩病的粗发病率和年龄调整发病率(每10⁵/年)分别为6.6和5.7,溃疡性结肠炎分别为2.4和1.9。克罗恩病年龄特异性发病率最高的年龄段为40 - 49岁(14.1),溃疡性结肠炎为80 - 89岁(6.8)。克罗恩病的男女比例为0.8,溃疡性结肠炎为1.1。克罗恩病诊断时的中位年龄为42.6岁,溃疡性结肠炎为35.3岁。
这些初步研究结果显示,该县克罗恩病发病率高,溃疡性结肠炎发病率低。然而,这些结果必须谨慎对待,因为这些数据仅记录了两年,且归类为可能和急性结肠炎的炎性肠病需要随访。