BACKGROUND:The determinants for recurrence of Crohn's disease remain controversial. Eight factors that might predict recurrence were studied in 130 patients operated on for Crohn's disease over a 24-year period.

METHODS:Separate survival curves were estimated for each variable. A multivariate analysis was then carried out in which several selected explanatory variables were included simultaneously in a proportional hazards regression model.

RESULTS:Operation for recurrent disease was necessary in 36 patients. Univariate analysis revealed a highly significant relationship between the presence of granulomas and subsequent recurrence (P = 0.003). There was a trend towards increased recurrence in patients with ileocolonic disease and segmental colectomy (P = 0.11 and P = 0.1 respectively). Age, sex, length of history, indication for operation and affected lines of transection were not associated with recurrence. After multivariate analysis, the association of granulomas with recurrence remained significant (P = 0.03). This association persisted when death was regarded as a treatment failure (P = 0.02).

CONCLUSION:The presence of granulomas in patients with Crohn's disease is significantly associated with recurrence.

译文

背景:克罗恩氏病复发的决定因素仍有争议。在24年的时间里,对130位接受克罗恩病手术的患者进行了八项可能预测复发的因素的研究。

方法:估计每个变量的独立生存曲线。然后进行了多变量分析,其中在比例风险回归模型中同时包含了几个选定的解释变量。

结果:36例患者必须进行复发性疾病手术。单因素分析显示肉芽肿的存在与随后的复发之间存在高度显着的相关性(P = 0.003)。回肠结肠疾病和节段性结肠切除术的患者有增加复发的趋势(分别为P = 0.11和P = 0.1)。年龄,性别,病史长度,手术指征和横断线均与复发无关。经过多变量分析,肉芽肿与复发的关联仍然很显着(P = 0.03)。当死亡被视为治疗失败时,这种关联仍然存在(P = 0.02)。

结论:克罗恩病患者肉芽肿的存在与复发密切相关。

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