| Abstract | Cilj istraživanja: ispitati zahvaćenost crijeva bolešću i usporediti s težinom simptoma i
postojanjem EIM-a. Ispitati povezanost duljine simptoma prije dijagnoze s odgovorom na
inicijalnu terapiju. Ispitati razliku u odgovoru na terapiju između IBD-a. Ispitati spolne i dobne
razlike u težini kliničke slike i postojanju zaostajanja u razvoju.
Nacrt studije: kohortna studija.
Ispitanici i metode: ispitanici su pedijatrijski pacijenti oboljeli od IBD-a. Podaci su uzeti iz
Nacionalnog registra djece oboljele od kroničnih upalnih bolesti crijeva u Republici Hrvatskoj.
Rezultati: pacijenti sa šire lokaliziranim CB-om imaju težu kliničku sliku (P = 0,023). U CB-u
težu kliničku sliku prati i viši EIM (P = 0,032). Najviši je EIM kod kolonične forme CB-a; u 6
(25 %). Ranije administrirana terapija u CB-u pokazala je veću vjerojatnost za pozitivan
odgovor (P = 0,05). Djevojčice imaju težu kliničku sliku prema PCDAI (P = 0,005), posebno
starije (P < 0,001). Kod UC-a, djevojčice imaju viši PUCAI od dječaka iste dobi (P < 0,001).
Kod CB-a i djece mlađe od 12 godina, dječaci bolje napreduju (P < 0,001). Mlađi dječaci s CBom bolje napreduju od starijih (P = 0,002), dok je kod djevojčica obrnuto (P = 0,005). Kod UCa mlađi dječaci imaju normalniji BMI (P = 0,045).
Zaključak: kod CB-a važno je pratiti lokalizaciju upale radi praćenja progresije i prevencije
komplikacija. Rana dijagnoza u CB-u poboljšava odgovor na terapiju. Djevojčice s IBD-om
treba češće kontrolirati jer pokazuju težu kliničku sliku i češće nazaduju u razvoju. Potrebno je
pratiti rast starijih dječaka s CB-om u odnosu na zdrave vršnjake. Kod UC-a nema značajnih
razlika u spolu, no ipak je potrebno prevenirati zaostajanje. |
| Abstract (english) | Objectives: To examine the correlation between disease distribution, severity of symptoms and
the existence of EIM. To examine the relationship between the length of symptoms before
diagnosis and the response to initial therapy. Additionally, to explore differences in therapy
response between IBD types and the role of gender and age in symptom severity and
developmental delay.
Study Design: A cohort study
Participants and methods: The participants are pediatric IBD patients, with data sourced from
Croatia's National Register of Children with Chronic Inflammatory Bowel Diseases.
Results: Patients with more than one localization of inflammation in Crohn's disease had a more
severe clinical presentation (P = 0,023). In Crohn's disease (CD), patients with a severe clinical
presentation also had more EIM (P = 0,032). Most EIMs were prevalent in patients who had
the colonic form of Crohn's disease; in 6 (25 %) patients. Children with Crohn's disease who
received early therapy were more likely to respond to it (P = 0,05). Girls had more severe
PCDAI score (P = 0,005), especially as they aged (P < 0,001). In ulcerative colitis, girls had
significantly higher PUCAI scores than boys of the same age (P < 0,001). Among children with
Crohn's disease under 12 years, boys grew better than girls (P < 0,001) and also thrive better
than older boys (P = 0,002), while the opposite was found for girls (P = 0,005). In ulcerative
colitis, there was no significant gender difference in growth, but younger boys had more normal
BMI values (P = 0,045).
Conclusion: In CD, tracking the location of inflammation is essential to assess disease
progression and prevent complications. Timely diagnosis in CD enhances treatment
effectiveness. Female patients with IBD should be monitored more frequently, as they tend to
exhibit a more severe clinical presentation and are at a higher risk of developmental regression.
It is important to keep an eye on the growth of older boys with CD in comparison to their
healthy counterparts. Although there are no major gender differences in Ulcerative Colitis,
measures should still be taken to prevent growth impairment. |
