Clinical and therapeutic features of 85 Chinese patients and 68 American patients with Crohn's disease:Retrospective analysis from 1985 to 2004
- VernacularTitle:中国Crohn病患者85例与美国Crohn病患者68例临床特征及治疗手段:1985~2004年回顾性分析
- Author:
Qingsen LIU
;
Li LI
;
Chenghua LUO
;
Yunsheng YANG
- Publication Type:Journal Article
- From:
Chinese Journal of Tissue Engineering Research
2007;11(38):7714-7717
- CountryChina
- Language:Chinese
-
Abstract:
BACKGROUND: Crohn's disease is complex and lack of specificity; meanwhile, it is related to diseased regions, areas,severity and complications in intestine. Otherwise, it is difficult to diagnose. The etiological factors are still unclear and radical therapy is lack recently. Therefore, clinical manifestations and therapeutic measures of Crohn' disease at home are different from those abroad.OBJECTIVE: To compare the clinical characteristics and therapeutic differences between the Chinese and American patients with Crohn's disease.DESIGN: Retrospective case analysis.SETTING: Department of Digestion, General Hospital of Chinese PLA.PARTICIPANTS: A total of 85 Chinese patients with Crohn's disease were selected from General Hospital (the 301 Hospital) of Chinese PLA from 1985 to 2004; meanwhile, a total of 68 American patients with Corhn's disease were selected from Cleveland Clinic Florida (CCF) from 1985 to 2004. Diagnostic criteria were based on WHO standards and all patients were diagnosed according to endoscope, X-ray manifestations and pathological characteristics.METHODS: Clinical data, including age, sex, family history, external manifestations of intestine, diseased regions and characteristics, drug treatment and surgical therapy, were compared between Chinese and American patients.Otherwise, enumeration data were compared with Chi-square test.MAIN OUTCOME MEASURES: Age, sex, family history, extra intestinal manifestations, diseased regions and characteristics, drug treatment and surgical therapy of Crohn's disease.RESULTS: ① General status and extra intestinal manifestations of intestine: The ratio of male and female patients in the 301 hospital was 1.74:1 and in CCF was 1:1.43. The incidences of positive family history and extra intestinal manifestations were 7% and 34%, which were higher in CCF than those in the 301 hospital (1%, 14%, x2=4.631 2, 8.315 0,P < 0.05). ② Diseased regions and pathological characteristics: The terminal ileum was involved at most (69%) and no patients had perianal diseases in the 301 hospital and the main pathological characteristics were ulcer (66%) and obstruction (14%). Those were higher than those of patients in CCF (25%, 4%, x2=25.309 2, 4.024 6, P< 0.05).Compared with the 301 hospital, the patients in CCF had more pathological changes in colon and rectum and more perianal diseases and intra-abdominal fistulas were involved (51%). The incidences of perianal diseases and intra-abdominal fistulas were 51% and 9%, which were higher than those of patients in the 301 hospital (0, 6%, x2=38.429 0, 0.148 2, P < 0.05). ③ Therapy: The main selections of medicine were sulfasalazine salicylazosulfapyridine (SASP, 54%), 5-aminosalicvlic acid (5-ASA, 19%) and metronidazole (21%) in 301 hospital, but in CCF, steroids (60%),azathioprine (34%) and infliximab (46%) were the main selections of medicine. Rates of surgical therapy were higher in CCF than those in the 301 hospital (96%, 49%, x2=36.145 9, P < 0.01).CONCLUSION: There are significant differences in clinical characteristics and therapeutic measures between Chinese and American patients with Crohn's disease, which is one of the reasons for the two hospitals to take different treatments.