The Changing Profiles Of Inflammatory Bowel Disease In China-a 15 Year Review Of IBD Cases To A Large Hospital In Eastern China

Background:We analyzed the admission and treatment data of Inflammatory Bowel Disease (IBD) patients at one hospital located in eastern China during a 15 year period to identify any changing trends in the incidence, prevalence and therapy provided for Ulcerative Colitis (UC) or Crohn's disease (CD).Methods:This is a retrospective analysis of hospitalized patients with a diagnosis of IBD in Sir Run Run Shaw Hospital, Zhejiang Province from 1 January 1995 to 31 December 2009. Clinical and epidemiological data were collected in our IBD database and analyzed. The study population was divided into 4 groups based on the diagnosis and year of admission. (Group A1=UC,1995-2004; Group B1=UC,2005-2009; Group A2=CD, 1995-2004; Group B2=CD,2005-2009). Comparisons were made between the groups to ascertain any changes in the epidemiology of the two diseases.Result:Over the 15 year period,427 hospitalized patients were registered. The mean IBD incidence of hospitalization was 1216/106 in Group A and 1910/106 in Group B, The incidence of hospitalization increased 1.6 times during 15 years. In group Al and A2, the mean incidence of hospitalization was 833/106 and 383/106 respectively; In Group B1 and B2, It was 956/106 and 954/106 respectively.The incidence of hospitalization of CD is growing faster than UC in the past 15 years. The incidence of hospitalization of CD surpassed of UC in 2009 (P=0.009 P＜0.01)。 For UC, the mean age at diagnosis was 47.5 years, male/female ratio 1.04:1, the rates of colectomy, mortality and familial aggregation were 7.6%,0.4% and 0.4% respectively. For CD, the mean age at diagnosis was 34.5 years, male/female ratio 1.48:1, the rates of colectomy, mortality and familial aggregation were 18.4%,0.9% and 1.7% respectively. There were no significant differences in the mean age of diagnoses, the sex ratio, the rates of colectomy, mortality and familial aggregation in the past 15 years. The applications of SASP/5-ASA, corticosteroids, immunosuppressive agents and infliximab in Group B were higher than the Group A (P＜0.05).Conclusion:During the past 15 years, the incidence of IBD has gradually increased in eastern China, The increase in CD was particularly remarkable. The sex ratio and the rates of colectomy, mortality and familial aggregation of IBD did not change significantly. However, the use of immunosuppressive agents and biologic agents is increasing.