摘要
目的:应用维也纳(Vienna)和蒙特利尔(Montreal)临床分类标准,探讨我国克罗恩病的临床表型特点。方法:回顾分析湘雅二医院和湘雅医院共168例住院克罗恩病患者的临床资料,按照Vienna、Montreal标准分别进行分型,对比分析两标准中各亚型特征。结果:Montreal标准的小于等于16岁A1亚型9例仅占5.4%,发病年龄主要集中在17～40岁,占63.1%,与Vienna标准小于40岁亚型的65.5%一致。累及部位均以回肠和回结肠亚型为主,Montreal标准的L4亚型7.1%明显少于Vienna标准的L4亚型13.7%(P=0.049)。疾病行为的狭窄亚型在Vienna、Montreal标准中分别为40.5%和41.7%,是主要的并发症,Montreal标准的穿透亚型为10.7%,明显低于Vienna标准的18.5%(P=0.044)。在Montreal标准下穿透行为的手术率为88.9%,明显高于Vienna标准的54.8%(P=0.014)。结论:我国青少年克罗恩病极少,仍以17～40岁患者居多,累及部位以回肠和回结肠亚型为主,并发症以狭窄常见,穿透是手术的主要原因。Vienna、Montreal标准对我国克罗恩病患者分型各有优势,目前综合应用Vienna、Montreal标准对我国克罗恩病进行临床分型可能更有价值。
Objective To investigate the phenotypic clinical expression of Crohn＇s disease in Chinese people using the Vienna and the Montreal classification. Methods We retrospectively analyzed the clinical data of 168 patients with Crohn＇s disease, then typed the disorder according to the Vienna and the Montreal classification, and then compare the features of each subtype. Results On the Montreal classification, patients with A1 subtype （only 5.4%） were at the age of less than or equal to 16, while most patients （63.1%） were 17 to 40, in consistency with the rate of the patients under 40 （65.5%） on the Vienna classification. Disease was mainly localized in the ileum and the ileocolon. Fewer patients with L4 subtype were found on the Montreal than on the Vienna classification （7.1% vs. 13.7% ,P = 0.049）. Stricture formation was the major complication （40.5% on the Vienna and 41.7% on the Montreal）, and penetration was less on the Montreal than on the Vienna classification （10.7% vs. 18.5% ,P = 0.044）. The surgery rate for penetrating behavior was much higher on the Montreal than on the Vienna classification （88.9% vs. 54.8%, P = 0.014）. Conclusions In China, Crohn＇s disease is rare in adolescents and occurs mainly in people at the age of 17 to 40. The disease is mainly localized in the ileum and the ileocolon. Stricture formation is a common complication and penetration is the major cause of surgery. Both the Vienna and the Montreal classification have their own advantages in typing Crobn＇s disease and thus combined application of the two classifications is more valuable.
出处
《实用医学杂志》
CAS
北大核心
2010年第1期47-49,共3页
The Journal of Practical Medicine
