摘要
目的探讨张家港市克罗恩病(CD)的发病率、患病率及疾病特征。方法采用横断面调查研究,于2017年1月1日至12月31日通过义诊及对张家港市5家医院(张家港市第一人民医院、张家港市中医院、张家港澳洋医院、张家港市锦丰人民医院和张家港乐余医院)的病历检索,收集并纳入户籍地址为张家港市且明确诊断为CD的患者。通过问卷调查收集患者的一般临床资料及流行病学数据,计算2017年张家港市CD的年龄标准化发病率和患病率。描述CD患者的临床特征,采用单因素分析和多因素Logistic回归方法分析诊断延迟的独立影响因素。结果共纳入CD患者123例,其中2017年新确诊患者14例。该市2017年的CD年龄标准化患病率为12.08/10万人,年龄标准化发病率为1.54/10万人。患者男73例,女50例,男女比例为1.46∶1;确诊年龄39(27,51)岁;20~29岁、40~49岁为高发年龄段,对应患者分别为27例(21.95%)、25例(20.33%);病程45(24,82)个月。疾病位于回肠末端72例(58.5%),其中2例(1.6%)累及上消化道;位于结肠28例(22.8%);位于回结肠23例(18.7%)。71例(57.7%)患者病变表现为非狭窄非穿透型,42例(34.1%)为狭窄型,10例(8.1%)为穿透型;23例(18.7%)患者伴有肛周病变。96例(78.0%)患者使用5-氨基水杨酸类药物,64例(52.0%)采用营养支持。63例(51.2%)患者出现诊断延迟,诊断延迟时间为8(2,36)个月。多因素分析提示肛周病变(OR=4.081,95%CI:1.159~14.367,P=0.029)是患者诊断延迟的独立危险因素,而城镇户口(OR=0.169,95%CI:0.073~0.393,P<0.001)则是独立保护因素。结论张家港市CD患者患病率和发病率较高,男性多见,确诊年龄趋势呈双峰型。疾病多累及回肠末端,多为非狭窄非穿透型。5-氨基水杨酸类药物和营养支持是常用的治疗方法。超半数患者出现诊断延迟,伴有肛周病变的患者发生诊断延迟的风险高,而城镇户口患者发生诊断延迟的风险低。
Objective To investigate the incidence,prevalence and disease characteristics of Crohn′s disease(CD)in Zhangjiagang city.Methods A cross-sectional study was conducted.During the period of January 1st to December 31st,2017,through a voluntary consultation and the medical records retrieval of 5 hospitals in Zhangjiagang city(the First People′s Hospital of Zhangjiagang,Zhangjiagang Hospital of Traditional Chinese Medicine,Zhangjiagang Aoyang Hospital,Zhangjiagang Jinfeng People′s Hospital and Zhangjiagang Leyu Hospital),the patients who were the registered residents of Zhangjiagang city and diagnosed as CD were collected and included in the study.The general clinical data and epidemiological data were collected by the questionnaire.The age-standardized prevalence and incidence of CD in Zhangjiagang city in 2017 was calculated.The clinical characteristics were described.The single factor analysis and multivariate Logistic regression analysis were performed to identify the independent influencing factors for delayed diagnosis.Results A total of 123 CD patients were included and 14 patients were newly diagnosed in 2017.The age-standardized prevalence of CD was 12.08 per 100000 persons in this city in 2017 and the age-standardized incidence was 1.54 per 100000 persons.There were 73 male patients and 50 female patients,the ratio of male to female was 1.46∶1.The age at diagnosis was 39(27,51)years old.The peak ages of diagnosis were 20 to 29 years old and 40 to 49 years old and there were 27(21.95%)and 25(20.33%)patients in the two ages respectively.The duration was 45(24,82)months.The disease involved the terminal ileum in 72 patients(58.5%)including 2(1.6%)in the upper gastrointestinal tract simultaneously,the colon in 28(22.8%)and the ileocolon in 23(18.7%).The non-stricturing non-penetrating type of disease was observed in 71 patients(57.7%),stricturing type in 42 patients(34.1%),penetrating type in 10 patients(8.1%).Twenty-three patients(18.7%)had simultaneous perianal disease.5-aminosalicylic acid was used i
作者
解好好
郭坤
李原
李冠炜
方淼
李伟杰
郑涛
涂建成
顾国胜
任建安
Xie Haohao;Guo Kun;Li Yuan;Li Guanwei;Fang Miao;Li Weijie;Zheng Tao;Tu Jiancheng;GuGuosheng;Ren Jian′an(Research Institute of General Surgery,Jinling Hospital,Nanjing University,School of Medicine,Nanjing 210002,China;Department of General Surgery,The First People′s Hospital of Zhangjiagang,Suzhou 215600,China)
出处
《中华炎性肠病杂志（中英文）》
2021年第2期145-150,共6页
Chinese Journal of Inflammatory Bowel Diseases
基金
江苏省医学杰出人才项目(JCRCB2016006)
军事医学创新工程项目(16CXZ007)。
关键词
克罗恩病
流行病学
发病率
患病率
诊断
延迟
Crohn′s disease
Epidemiology
Incidence
Prevalence
Diagnosis,delayed
