瑞典儿童中乳糜泻的发病率上升:喂养建议、血清学筛查以及小肠活检的影响

作     者：Laurin P. Stenhammar L. Flth- Magnusson K. 程欣 

作者机构：Division of Paediatrics Dept. of Molec. and Clin. Medicine Linkping Universitet SE-581 85 Link opingsSweden Dr. 

出 版 物：《世界核心医学期刊文摘（胃肠病学分册）》 (Core Journals in Gastroenterology)

年 卷 期：2005年第1卷第3期

页      面：59-59页

学科分类：1002[医学-临床医学] 100202[医学-儿科学] 10[医学] 

主　　题：血清学筛查 乳糜泻 抗体分析技术 累积发病率 活检结果 婴儿喂养 抗体检测结果 特定地区 抗肌内膜抗体 疑似病例 

摘      要：Background: The prevalence of coeliac disease (CD) in Swedish children has attracted considerable interest over the past few decades, and especially the influence of feeding habits on the increased incidence. A national study has reported a trend towards a decrease in incidence after a change in infant feeding recommendations was introduced in 1996. The aim of this study was to evaluate, in a geographically defined area, the change in incidence with time and the influence of the introduction of antibody analysis. Methods: Cases of suspected paediatric CD between 1980 and 2003 were studied for prevalence, biopsy findings and antibody analyses. Results: A total of 2029 children were investigated by small intestinal biopsy, yielding 554 CD cases. The area initially showed the same trend as the national study, but the annual incidence rate is now increasing again. Median age at diagnosis has increased significantly since 1997 from less than 2 years of age to above 5 years. Cumulative incidence at 2 years of age is much higher for the birth cohorts 1983-96 than 1980-82 or 1997-2001. Diagnostic accuracy was significantly higher after the introduction of antigliadin (AGA) analysis, and especially after anti endomysium (EMA) analysis. Conclusions: The incidence rate of CD in small children in our region has varied widely over the 24-year period observed. Feeding practice and methods of investigation have changed during this period. The annual incidence rate for the total child population in 2003 was almost equal to the peak value observed in 1994. There were no conclusive results on whether antibody analysis had an influence on diagnostic activity, but this seems to have increased diagnostic accuracy.