成人乳糜泻的高发病率和患病率。强化诊断方法。
High incidence and prevalence of adult coeliac disease. Augmented diagnostic approach.
作者信息
Collin P, Reunala T, Rasmussen M, Kyrönpalo S, Pehkonen E, Laippala P, Mäki M
机构信息
Dept. of Internal Medicine, Tampere University Hospital, University of Tampere, Finland.
出版信息
Scand J Gastroenterol. 1997 Nov;32(11):1129-33. doi: 10.3109/00365529709002992.
BACKGROUND
The diagnosis of coeliac disease is easily overlooked as patients can present with mild or atypical symptoms, or the condition can even be clinically silent. Our aim was to detect coeliac disease patients with such atypical or no symptoms as well as those with typical features.
METHODS
The incidence of adult coeliac disease in Tampere was calculated from 1975 to 1994 and the prevalence as of 31 December 1994. Open-access endoscopy was available for general practitioners, and small-bowel biopsy was done routinely. Serologic screening was applied to patients with an increased risk of coeliac disease.
RESULTS
The incidence of coeliac disease increased tenfold, and the prevalence was 270 per 100,000 inhabitants in 1994. Twenty per cent were found by serologic screening and 10% as a result of routine biopsy; 24% had dermatitis herpetiformis.
CONCLUSIONS
Our diagnostic approach gave a coeliac prevalence similar to that found in population screening studies. One-third had silent coeliac disease.
背景
乳糜泻的诊断很容易被忽视，因为患者可能表现出轻微或非典型症状，甚至在临床上可能毫无症状。我们的目的是检测出有此类非典型症状或无症状的乳糜泻患者以及有典型症状的患者。
方法
计算了1975年至1994年坦佩雷地区成人乳糜泻的发病率以及截至1994年12月31日的患病率。全科医生可进行开放式内镜检查，并常规进行小肠活检。对乳糜泻风险增加的患者进行血清学筛查。
结果
乳糜泻的发病率增加了九倍，1994年的患病率为每10万居民270例。20%是通过血清学筛查发现的，10%是常规活检的结果；24%患有疱疹样皮炎。
结论
我们的诊断方法得出的乳糜泻患病率与人群筛查研究中的结果相似。三分之一的患者患有无症状乳糜泻。
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