美国与中国两组结直肠克罗恩病患者临床表现及病情严重程度比较

目的 探讨美国与中国结直肠克罗恩病患者临床病理特征及病情严重程度的差异.方法 自1985年3月至2004年9月,收集美国Cleveland Clinic Florida 68例（美国组）和中国北京解放军总医院85例（中国组）结直肠克罗恩病患者.比较两组患者一般资料、肠外病变、发病部位、临床表现、病理特征的差异.结果美国组和中国组女性患者分别占60.3%和36.5%（P=0.003）,有家族史者分别占11.8%和1.2%（P=0.016）;两组出现脓肿、直肠阴道瘘及肠外病变的概率分别为19.1%和0（P＜0.001）、51.5%和0（P＜0.001）、39.7%和20.0%（P=0.013）;上述差异均有统计学意义.美国组有30例（44.1%）病变累及全结肠,而中国组仅4例（4.7%）（P＜0.001）;美国组回盲部以远各肠段受侵率均显著高于中国组（均P＜0.05）.结论 与中国患者相比,美国结直肠克罗恩病患者以女性多见,多有家族史,病变常累及远侧结直肠,临床表现及病理改变更为严重.

Comparison of clinical manifestation and severity between hospital-based American and Chinese patients with colorectal Crohn disease

Objective To evaluate the differences in clinicopathological characteristics and severity between American and Chinese patients with colorectal Crohn disease (CD). Methods Between March 1985 and September 2004, 68 patients with colorectal CD in Cleveland Clinic Florida (America)and 85 patients with colorectal CD in the 301 Hospital (China) were enrolled in the study. Data of two groups,including demographics, clinical characteristics, extraintestinal manifestations, presenting symptoms, location and pathological characteristics,were compared. Results 60.3% of American patients and 36.5% of Chinese patients were female (P=0.003). 11.8% of American patients and 1.2% of Chinese patients had a family history of CD(P=0.016). American patients had a significantly higher rate of extraintestinal disease (39.7% vs 20.0%), abscess(19.0% vs 0), and anorectal fistulas(51.5% vs 0). American patients had significantly more extensive disease than Chinese patients (pancolitis:44.1% vs 4.7% ,P＜0.01). American patients had a significantly higher rate of disease involving the ascending colon, transverse colon, descending colon, sigmoid colon, anorectal area compared with Chinese patients (all P＜0.05). Conclusions American patients with colorectal Crohn disease seem to have a female predominance, a higher rate of CD family history, to involve the distal intestinal tract more often,and have more severe clinical manifestation and pathological process, as compared with Chinese patients.