Clin Gastroenterol H:肛周克罗恩病与疾病不良预后相关

2021-04-29 MedSci原创 MedSci原创

尽管免疫调节剂和生物制剂的利用率更高,但PCD与不良疾病预后相关,尤其是在严重的PCD患者中。

基于人群的数据已经探究了肛周累及的克罗恩病(CD)的情况,并比较了严重和非严重肛周CD(PCD)的病程。

近日,消化病领域权威杂志Clinical Gastroenterology and Hepatology发表了一篇研究文章,研究人员旨在通过基于人群的CD研究来探索这些表型的病程。

研究人员从EpiII-IIRN队列中确定了病例,其中包括两个以色列卫生维护组织,覆盖了78%的人口。研究人员验证了特定的算法,以确定瘘管型PCD,并通过药物利用、ICD-9代码和肛周手术来区分严重和非严重疾病。

自2005年起,共有12904名CD患者被纳入研究(2186名[17%]小儿发病),完成了86119人次每年的随访。1530名(12%)患者(574名[4%]患有严重PCD)被诊断为瘘管型PCD。从CD诊断开始的第一年、第三年、第五年和第十年,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(非PCD患者为36%,PCD患者为64%;p<0.001)、接受IBD相关手术(分别为9% vs. 38%;p<0.001)以及发展为肛门直肠癌(非PCD患者为1.2/10000人次每年,而PCD患者为4.2/10000人次每年;p=0.01)的可能性更高。与非重度PCD相比,重度PCD与较差的结局相关,如住院(非重度PCD为61%,重度为73%;p=0.004)和手术(35% vs. 43%;p=0.001)。

由此可见,尽管免疫调节剂和生物制剂的利用率更高,但PCD与不良疾病预后相关,尤其是在严重的PCD患者中

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.https://www.cghjournal.org/article/S1542-3565(21)00395-5/fulltext

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    2021-06-04 许安
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    2021-04-29 huhuanyi

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