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Clin Gastroenterology H: 炎性肠病患者接受生物制剂治疗后肠道切除的概率明显降低

2020-10-15 MedSci原创 MedSci原创

50%至80%的克罗恩病(CD)患者和10%至30%的溃疡性结肠炎(UC)患者在其一生中都需要接受手术治疗。生物疗法可能会改变这种疾病进程,但在该患者人群中,生物制剂对手术率的影响尚不清楚。

背景和目标

50%至80%的克罗恩病(CD)患者和10%至30%的溃疡性结肠炎(UC)患者在其一生中都需要接受手术治疗。生物疗法可能会改变这种疾病进程,但在该患者人群中,生物制剂对手术率的影响尚不清楚。本项研究旨在探究生物制剂对CD和UC手术患病率的影响。

 

方法

研究人员使用美国医疗数据库对2015年至2020年之间所有诊断为CD或UC并接受任何生物制剂治疗的患者进行了回顾性研究。主要观察结果是生物制剂治疗与肠切除术患病率之间的关联。此外,还探究了与生物制剂和IBD患者手术相关的危险因素。

 

结果

医疗数据库中共有32904480位患者,研究人员确定了140540位CD患者和115260位UC患者,其中分别有25840(18%)和9050(7.8%)位患者接受了生物制剂治疗。与未接受生物制剂治疗的CD患者相比,经生物制剂治疗的CD患者的肠道切除术患病率(9.3%)显着较低(p <0.001)。同样,经生物制剂治疗的UC患者接受结肠切除术的可能性显着降低(11.0% VS 7.3%;p <0.001)。吸烟, 艰难梭菌感染和肛周疾病与CD肠切除有关。结肠肿瘤和艰难梭菌感染与UC结肠切除术有关。

 

 

结论

本项研究证实与从未接受过生物制剂治疗的炎症性肠病(IBD)患者相比,接受过生物制剂治疗的炎症性肠病患者的肠道切除可能性明显降低。

 

 

原始出处:

George Khoudari. Et al. Rates of Intestinal Resection and Colectomy in Inflammatory Bowel Disease Patients after Initiation of Biologics: A Cohort Study. Clinical Gastroenterology Hepatology. 2020.

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