IBD: 肝移植后患有原发性硬化性胆管炎的炎症性肠病患者临床预后较差

2020-01-29 不详 MedSci原创

炎症性肠病(IBD)疾病活动对原发性硬化性胆管炎(PSC)肝移植(LT)后长期结局的影响尚不清楚。因此,本项研究探究了LT后IBD活动对临床预后的影响。

背景
炎症性肠病(IBD)疾病活动对原发性硬化性胆管炎(PSC)肝移植(LT)后长期结局的影响尚不清楚。因此,本项研究探究了LT后IBD活动对临床预后的影响。

方法
本项研究收集了来自2个中心的112名接受LT进行PSC的患者,随访时间的中位值为7年。根据LT后IBD的活动将患者分为3组:无IBD,轻度IBD和中重度IBD活动。如果满足以下3个标准中的至少1个,则将患者分类为中度至重度IBD:(i)内窥镜检查可能是Mayo 2或3结肠炎或简单内镜评分–克罗恩病≥7;(ii)IBD急性发作需要类固醇抢救治疗;或(iii)LT后结肠切除术用于难治性IBD。

结果
移植后任何时候中度至重度IBD与艰难梭菌感染的风险较高(27%vs 8%轻度IBD vs 8%无IBD;P = 0.02),直肠癌/高度不典型增生(21%vs两组均为3%; P = 0.004),LT后结肠切除术(33%vs 3%vs 0%)和rPSC(64%vs 18%vs 20%; P <0.001)相关。多变量分析显示,中度至重度IBD增加了rPSC的风险(相对风险[RR],8.80; 95%置信区间[CI],2.81–27.59;P <0.001)和直肠癌/高度不典型增生(RR, 10.45; 95%CI,3.55–22.74;P <0.001)的风险。

结论
与轻度IBD和无IBD相比,LT后任何时间点出现中度至重度IBD与rPSC和结直肠瘤形成的风险更高有关。

原始出处:

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    2020-01-31 bnurmamat
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