AP&T: 儿童炎症性肠病抗TNF-α的使用可降低儿童时期手术切除率

2019-02-16 不详 MedSci原创

随着理念的进步,目前儿童期炎症性肠病(PIBD)的抗肿瘤坏死因子-α的使用率已经大大增加。但这是否已经改变/延迟儿童期的手术尚不确定,因此本项研究旨在探明儿童炎症性肠病抗TNF-α的使用是否可以降低儿童时期手术切除率

背景
随着理念的进步,目前儿童炎症性肠病(PIBD)的抗肿瘤坏死因子-α的使用率已经大大增加。但这是否已经改变/延迟儿童期的手术尚不确定,因此本项研究旨在探明儿童炎症性肠病抗TNF-α的使用是否可以降低儿童时期手术切除率

方法
研究人员评估1997年至2017年在Wessex医疗中心被诊断患有PIBD的患者的临床信息,并分析了儿童期(<18岁)中抗TNF治疗和年度手术率(包括肛周手术)。

结果
本项研究共纳入了825名儿童(498名克罗恩病,272名溃疡性结肠炎,55名IBD未分类),诊断时平均年龄为13.6岁(1.6-17.6),女性为39.6%。抗TNF治疗患者从5.1%增加到27.1%(2007-2017)。手术切除率下降(7.1%-1.5%,P  = 0.001),肛周手术和溃疡性结肠炎切除率没有变化。从诊断到切除的时间增加(1.6 – 2.8年,P = 0.028),但切除的平均年龄没有变化。在儿童期接受切除术的患者在最近5年内被诊断为年龄较小(2007-2011 = 13.1岁,2013-2017 = 11.9岁,P  = 0.014)。使用多元回归分析显示,抗TNF治疗是手术切除率的唯一显着预测指标(P  = 0.011)。

结论
抗TNF治疗使用率近年来显着增加,抗 TNF治疗可以减少儿童期外科手术干预的需要,从而影响PIBD的自然史。

原始出处:

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    2019-04-09 mfx808
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    2019-02-18 snowpeakxu
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