Clin Gastroenterology H:肛周克罗恩病与疾病预后不良相关

2021-04-22 MedSci原创 MedSci原创

克罗恩病可以在全身的消化道中发病,当然最常见的是回盲部和末端回肠,但是有部分患者会出现肛周病变,肛周克罗恩病(PCD)的表现形式有很多如肛裂,肛瘘和肛周脓肿。

      克罗恩病可以在全身的消化道中发病,当然最常见的是回盲部和末端回肠,但是有部分患者会出现肛周病变,肛周克罗恩病(PCD)的表现形式有很多如肛裂,肛瘘和肛周脓肿,有时疾病表现可能会很复杂。本项研究旨在探究有肛周病变的克罗恩患者是不是会导致更严重的疾病行为和预后更加不良。

 

      自2005年起,共有12,904名CD患者被纳入本项研究(其中包括2,186名儿童),总共收集到了86,119人年的随访记录。1,530名(12%)患者患有PCD,574名[4%]患有严重PCD。从CD诊断开始的第一年,第三年,第五年和十年,PCD的患病率分别为7.9%,9.4%,10.3%和11.6%。五年后,PCD患者住院的可能性更高(非PCD患者为36%,PCD患者为64%; p <0.001),接受IBD相关手术(9%vs 38%; P <0.001)并发展肛门直肠癌(非PCD患者为1.2 / 10,000人年,而PCD患者为4.2 / 10,000人年; p = 0.01)的机会也更大。与非严重PCD相比,重度PCD与较差的结局相关。

图:肛周克罗恩病对于患者预后的影响

       虽然目前对着治疗克罗恩病的药物愈加丰富,免疫调节剂和生物制剂的利用率越来越高,但PCD的治疗效果仍然欠佳,而且PCD与疾病预后不良相关,尤其是在严重的PCD中这样的关系更明显。

 

 

原始出处:

Ohad Atia. Et al. Perianal Crohn’s disease is associated with poor disease outcome: a nation-wide study from the epiIIRN cohort. Clinical Gastroenterology and Hepatology.2021.

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    2021-04-24 汉水人家

    三人行,必有我师

    0

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    2021-04-23 梅斯小助手

    三人行,必有我师。 #梅斯医学科研互助群# 欢迎您的加入,添加【梅斯医学科研助手WeChat:medsci_2021】邀您进群! 【社群简介】👉 梅斯医学目前已建立覆盖肿瘤、心血管、神经、消化、内分泌、呼吸等30个科室的学习交流社群。 【入群福利】👉 群内可实时交流病例,提问同行,跨群讨论,每天更新前沿医学资讯和指南共识,每周推出至少1场专业直播,不时共享科研干货,入群即可获得100份SCI写作攻略!

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