摘要
目的总结炎症性肠病(IBD)患儿的临床资料,包括克罗恩病(CD)和溃疡性结肠炎(UC),比较极早发型IBD(VEO-IBD)和晚发型IBD(LO-IBD)患儿的临床特征。方法对2000年1月至2014年12月在首都医科大学附属北京儿童医院确诊的184例IBD住院患儿的临床资料进行回顾性分析,按照患儿发病年龄分为VEO-IBD组(<6岁)和LO-IBD组(6~16岁);CD患儿分为VEO-CD组(<6岁)和LO-CD组(6~16岁);UC患儿分为VEO-UC组(<6岁)和LO-UC组(6~16岁)。比较各组IBD患儿的临床特征。结果184例IBD患儿中,VEO-IBD 77例(41.8%),LO-IBD 107例(58.2%)。临床表现方面,VEO-CD组患儿腹痛的发生率明显低于LO-CD组,差异有统计学意义(P<0.05),腹泻、便血的发生率明显高于LO-CD组,差异均有统计学意义(均P<0.05);VEO-UC组患儿腹痛的发生率明显低于LO-UC组,差异有统计学意义(P<0.001),腹泻、发热、口腔溃疡的发生率明显高于LO-UC组,差异均有统计学意义(均P<0.05)。按照蒙特利尔分型,VEO-CD组和LO-CD组患儿均以回结肠型[15/27例(55.6%)、20/47例(42.6%)]、非狭窄非穿透型[20/27例(74.1%)、30/47例(63.8%)]、中-重度活动[23/27例(85.2%)、37/47例(78.7%)]为主。VEO-CD组患儿肛周病变的发生率高达51.9%(14/27例),明显高于LO-CD组(9/47例,19.1%),差异有统计学意义(P<0.05)。VEO-UC组患儿左半结肠型所占比例明显高于LO-UC组患儿,差异有统计学意义(P<0.05),广泛结肠型所占比例明显低于LO-UC组,差异有统计学意义(P<0.05)。VEO-UC组轻度活动患儿所占比例明显低于LO-UC组,差异有统计学意义(P<0.05),重度活动患儿所占比例明显高于LO-UC组,差异有统计学意义(P<0.05)。VEO-UC组患儿肠穿孔的发生率明显高于LO-UC组,差异有统计学意义(P<0.05)。LO-CD组患儿手术率、肠梗阻、肠穿孔的发生率均明显高于LO-UC组,差异均有统计学意义(均P<0.05)。结论VEO-IBD与LO-IBD比较,VEO-IBD患儿病情较重,合并肛周病变更为多见,肠穿孔的发生率更高。
Objective To summarize the clinical data of the children with inflammatory bowel diseases(IBD), including Crohn′s disease (CD) and ulcerative colitis (UC), and to analyze and compare the clinical features of very early-onset IBD (VEO-IBD) and late-onset IBD (LO-IBD). Methods A retrospective analysis of the clinical data of 184 cases of IBD hospitalized children diagnosed at Beijing Children′s Hospital, Capital Medical University from January 2000 to December 2014.According to their ages of onset, the patients were divided into VEO-IBD group (<6 years old) and LO-IBD group (6-16 years old);the patients with CD were divided into VEO-CD group (<6 years old) and LO-CD group (6-16 years old);UC were divided into VEO-UC group (<6 years old) and LO-UC group (6-16 years old). The clinical features among each group were analyzed and compared. Results A total of 184 IBD patients were included in the study, 77 cases(41.8%) were VEO-IBD and 107 cases(58.2%) were LO-IBD.Comparison between VEO-CD group and LO-CD group indicated that abdominal pain was more common in LO-CD group(P<0.05), while diarrhea and hematochezia were more common in VEO-CD group(all P<0.05). In addition, comparison between VEO-UC group and LO-UC group indicated that abdominal pain was more common in LO-UC group(P<0.001), while diarrhea, fever, and oral ulcers were more common in VEO-UC group (all P<0.05). Both VEO-CD and LO-CD group were mainly ileocolonic[15/27 cases (55.6%), 20/47 cases (42.6%)], non-narrow, non-penetrating [20/27 cases (74.1%), 30/47 cases (63.8%)] and moderate-to-severe activity[23/27 cases(85.2%), 37/47 cases (78.7%)]. The incidence of perianal lesions in the VEO-CD group was as high as 51.9%(14/27 cases), which was significantly higher than that in the LO-CD group (9/47 cases, 19.1%)(P<0.05). Left-sided UC and severe UC were more common in VEO-UC group(all P<0.05), while pancolitis and mild UC were more common in LO-UC group (all P<0.05). The incidence of intestinal perforation in the VEO-UC group was significantly higher than t
作者
官德秀
于飞鸿
王国丽
周锦
王大勇
徐樨巍
Guan Dexiu;Yu Feihong;Wang Guoli;Zhou Jin;Wang Dayong;Xu Xiwei(Departmenl of Gastroenterology, Beijing Children' sHospital, Facully of Digestive Diseases, Capital Medical Inirersity,National Clinical Research Center for Digestive Diseases, Beijing 100045, China;Department cf General Surgery, BeijingChildren's Hospital, Capital Medical I nirersily, Beijing 100045, China)
出处
《中华实用儿科临床杂志》
CSCD
北大核心
2019年第7期496-500,共5页
Chinese Journal of Applied Clinical Pediatrics
基金
首都临床特色应用研究与成果推广项目(ZI5I 1000()4015074).
关键词
炎症性肠病
极早发型
克罗恩病
结肠炎
溃疡性儿童
Inflammatory bowel disease, very early-onset
Crohn′s disease
Colitis, ulcerative
Child
