AJG: 嗜酸粒细胞性食管炎患者患精神疾病的风险更大

2022-07-05 xuyihan MedSci原创

嗜酸细胞性食管炎是一种以嗜酸性粒细胞浸润为主要特征的慢性食管炎症。主要临床表现为吞咽梗阻、食物嵌顿及反流样症状等。

嗜酸性食管炎 (EoE) 是一种主要影响男性的进行性慢性炎症性疾病。如果不及时治疗,该疾病会导致食管纤维化和狭窄。此类疾病的诊断主要基于临床症状,例如吞咽困难和食物嵌塞、组织学特征(每个高倍视野≥15 个嗜酸性粒细胞)。改善临床症状和提高整体生活质量 (QoL) 是此病治疗的基本目标。在一项回顾性研究中,833 名 EoE 患者中有 28% 患有精神疾病,另一项研究也发现有EoE患者中焦虑和抑郁的风险增加。由于缺乏前瞻性的基于人群的研究,本项研究进行了一项全国性的调查来评估 EoE 个体中精神疾病的发生频率。

 

 

这是一项基于大样本人群的全国性队列研究。通过收集瑞典28个病理学部门确定了 1989-2017年间在瑞典诊断出EoE的个体共1458例。EoE患者与最多5名性别、年龄相符合的参考个体相匹配(n = 6,436)。Cox 比例风险模型估计调整后的风险比 (HR)。在二次分析中,研究人员将患有 EoE 的个体与其兄弟姐妹进行了比较,以调整家族内的混杂因素。

 

 

研究结果显示:EoE诊断的中位年龄为39岁,76%的EoE患者为男性。在4年的中位随访期间,106名EoE个体(15.96/1,000人年)与 331 名参考个体(10.93/1,000 人年)相比出现了精神疾病,对应的HR为 1.50;(95%CI= 1.20–1.87)。在随访的前5年中观察到风险增加,但此后这样的趋势就消失了。在儿童期被诊断出患有 EoE 的个体中,相对风险最高。与兄弟姐妹相比,患有EoE的个体患精神疾病的风险增加(HR = 1.62;95%CI= 1.14-2.31)。EoE 与情绪障碍、焦虑障碍和注意力缺陷多动障碍有关。

 

 

本项研究证实与兄弟姐妹和一般人群相比,患有EoE的人患精神疾病的风险可能更大。在临床护理中需要考虑这种风险,以检测、预防和治疗合并症的发生。

 

 

 

原始出处:

Röjler, Lovis. Et al. Individuals With Eosinophilic Esophagitis Are at Greater Risk of Later Psychiatric Disorder. The American Journal of Gastroenterology.2022.

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    2022-07-05 ms3000000731310237

    感觉只要长期影响生活质量的病,就会加重精神疾病的发病风险

    0

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    2022-07-05 ms5000000644045955

    不错,学习了。

    0

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    2022-07-04 zhouqu_8
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    2023-04-03 minzju5052

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