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[慢性炎症性肠病的初始症状、肠外表现及妊娠过程]

[Initial symptoms, extra-intestinal manifestations and course of pregnancy in chronic inflammatory bowel diseases].

作者信息

Rath H C, Andus T, Caesar I, Schölmerich J

机构信息

Klinik und Poliklinik für Innere Medizin I, Klinikum der Universität Regensburg.

出版信息

Med Klin (Munich). 1998 Jul 15;93(7):395-400. doi: 10.1007/BF03042635.

Abstract

BACKGROUND

In many cases inflammatory bowel disease is accompanied by extraintestinal manifestations. This results in lowering of live quality. The aim of this study was to gather data retrospectively about initial symptoms, extraintestinal manifestations and course of pregnancy in a large unselected population with inflammatory bowel disease in South Germany.

PATIENTS AND METHODS

Data from 1975 to 1989 (392 patients) were analyzed and partially compared with data from 1992 to 1995 (211 patients).

RESULTS

Patients with Crohn's disease in average have been 25 years old at the time point of initial symptoms, whereas the age of ulcerative colitis patients was 30 years (p < 0.0001). The number of Crohn's disease patients with a long interval between initial symptoms and diagnosis (> 1 year) was significantly decreased in the second population (50% vs 38%; p < 0.05). Dominant initial symptoms in Crohn's disease were indisposition, abdominal pain and nonbloody diarrhea in contrast to ulcerative colitis which manifested mostly with bloody diarrhea. Extraintestinal manifestations occurred in 76% of patients with Crohn's disease and 64.6% with ulcerative colitis. Complications during the course of pregnancy have been detected in 40.5% in Crohn's disease and 60% in ulcerative colitis.

CONCLUSION

A better knowledge of initial symptoms and extraintestinal manifestations in inflammatory bowel disease can help to decrease the interval between initial symptoms and the diagnosis. Pregnancy in patients with inflammatory bowel disease needs to be treated with special care.

摘要

背景

在许多情况下,炎症性肠病伴有肠外表现。这会导致生活质量下降。本研究的目的是回顾性收集德国南部一大群未经过筛选的炎症性肠病患者的初始症状、肠外表现及妊娠过程的数据。

患者与方法

分析了1975年至1989年的数据(392例患者),并将其部分与1992年至1995年的数据(211例患者)进行比较。

结果

克罗恩病患者出现初始症状时的平均年龄为25岁,而溃疡性结肠炎患者的年龄为30岁(p < 0.0001)。第二批患者中初始症状与诊断间隔时间较长(>1年)的克罗恩病患者数量显著减少(50%对38%;p < 0.05)。克罗恩病的主要初始症状为不适、腹痛和非血性腹泻,而溃疡性结肠炎主要表现为血性腹泻。76%的克罗恩病患者和64.6%的溃疡性结肠炎患者出现肠外表现。克罗恩病患者妊娠期间的并发症发生率为40.5%,溃疡性结肠炎患者为60%。

结论

更好地了解炎症性肠病的初始症状和肠外表现有助于缩短初始症状与诊断之间的间隔时间。炎症性肠病患者的妊娠需要特别护理。

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