Kelly P, Patchett S, McCloskey D, Alstead E, Farthing M, Fairclough P
Digestive Diseases Research Centre, St Bartholomew's, London, UK.
Gut. 1997 Nov;41(5):688-9. doi: 10.1136/gut.41.5.688.
Primary sclerosing cholangitis develops in 3-10% of patients with ulcerative colitis, and may be associated with an increased cancer risk. Ulcerative colitis is probably less common in people of African origin than in populations of European descent.
To review the records of all patients under regular follow up for ulcerative colitis at St Bartholomew's Hospital (London, UK), a tertiary referral centre, prompted by discovering a cluster of cases with common features.
Among 166 patients with ulcerative colitis under regular follow up, only four (all women) are of African or Caribbean genetic origin, and three of these have developed sclerosing cholangitis within three years of presentation with colitis, compared with four of 162 patients of European or Asian descent (odds ratio 119, 95% confidence interval 8-3837; p = 0.0002). This cluster, which is not explained by common HLA DR or DQ type, suggests that Africans and Afro-Caribbeans, especially women, may be at increased risk of sclerosing cholangitis. This may reflect genetic influences on the development of enteric and hepatobiliary inflammatory disease.
原发性硬化性胆管炎在3% - 10%的溃疡性结肠炎患者中发生，且可能与癌症风险增加相关。溃疡性结肠炎在非洲裔人群中可能比欧洲裔人群中少见。
在英国伦敦的圣巴塞洛缪医院（一家三级转诊中心），由于发现一组具有共同特征的病例，促使我们回顾所有定期随访的溃疡性结肠炎患者的记录。
在166例接受定期随访的溃疡性结肠炎患者中，只有4例（均为女性）是非洲或加勒比遗传血统，其中3例在出现结肠炎后的3年内发生了硬化性胆管炎，而162例欧洲或亚洲血统的患者中有4例发生了硬化性胆管炎（比值比119，95%置信区间8 - 3837；p = 0.0002）。这组病例不能用常见的HLA DR或DQ类型来解释，提示非洲人和非裔加勒比人，尤其是女性，可能患硬化性胆管炎的风险增加。这可能反映了基因对肠道和肝胆炎症性疾病发生发展的影响。
