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Am J Gastroenterol:抑郁增加炎症性肠病患者复发风险

2017-11-17 zhangfan MedSci原创

研究认为,炎症性肠病患者抑郁症状会导致患者治疗后疾病复发风险增加

抑郁是炎症性肠病(IBD)患者常见并发症之一,近日研究人员评估了抑郁症状对炎症性肠病患者病情复发进展的影响。

研究人员对西奈-赫尔姆斯利试验结果数据进行了分析,考察参与者基线抑郁诊断情况,并在随访过程中考察基线抑郁症状对IBD疾病复发进展的影响。定义患者健康调查问卷(PHQ-8)得分超过5分为轻度抑郁;Harvey-Bradshaw指数≥5或单纯临床结肠炎活动指数>2为IBD复发,利用二项式回归计算调整后的风险比率。

研究人员对2798名克罗恩病患者进行了为期22个月的随访,对1516名溃疡性结肠炎患者进行了24个月的随访。64%的CD患者和45%的UC患者IBD症状基线缓解。20%的CD患者以及14%的UC患者自我报告存在抑郁症状,PHQ-8检测发现38%的CD患者以及32%的UC患者存在抑郁症状(P<0.01)。对性别、疾病缓解、疾病活动进行调整后,CD患者基线抑郁状态会导致IBD复发 (RR:2.3;95% CI:1.9-2.8), 手术或住院(RR:1.3 95% CI:1.1-1.6) 风险增加。UC患者基线抑郁状态会导致IBD复发 (RR:1.3;95% CI:0.9-1.7), 手术或住院(RR:1.3;95% CI:1.1-1.5) 风险增加。

研究认为,炎症性肠病患者抑郁症状会导致患者治疗后疾病复发风险增加。

原始出处:

Bharati Kochar et al. Depression Is Associated With More Aggressive Inflammatory Bowel Diseasey.Am J Gastroenterol.14 November 2017.

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GetPortalCommentsPageByObjectIdResponse(id=261973, encodeId=8d342619e3e3, content=学习了.涨知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=76, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220115/46bcf39c32de4aa6b45c5f9d66c8ee77/6cb4a20c55bb4b7691122f47747bfca2.jpg, createdBy=9dad1662329, createdName=1ddf0692m34(暂无匿称), createdTime=Fri Nov 17 09:59:08 CST 2017, time=2017-11-17, status=1, ipAttribution=)]
    2018-02-03 许安
  5. 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    2017-11-24 lou.minghong

    学习了谢谢分享!

    0

  6. 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  7. 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  8. 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    2017-11-18 sunfeifeiyang

    抑郁症致肠炎

    0

  9. 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    2017-11-17 sunfeifeiyang

    抑郁致肠炎

    0

  10. 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    2017-11-17 1ddf0692m34(暂无匿称)

    学习了.涨知识

    0

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抗肿瘤坏死因子α单克隆抗体治疗炎症性肠病专家共识(2017)

炎症性肠病( inflammatory bowel disease,IBD) 是一组病因尚不十分明确的慢性非特异性肠道炎性疾病,包括溃疡性结肠炎( ulcerative colitis,UC) 和克罗恩病( Crohn's disease,CD) 。治疗IBD 的抗肿瘤坏死因子α( tumor necrosis factor-α,TNF-α) 单克隆抗体包括人鼠嵌合体IgG1 单克隆抗体英夫利西单

2017 共识声明:抗肿瘤坏死因子治疗炎症性肠病治疗药物监测

炎症性肠病(IBD)接受抗肿瘤坏死因子(TNF)药物治疗进行治疗药物监测(TDM)可以协助优化疾病结局。本文的主要目的是确定TDM指导抗肿瘤坏死因子药物治疗IBD的循证共识声明。由25位来自澳大利亚和国际专家共同组成专家小组共提出了24条共识意见。

2017 AOCC/APAGE共识:接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估

2017年10月,亚洲克罗恩病和结肠炎组织(AOCC)联合亚太地区胃肠病学协会(APAGE)共同发布了接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估和管理共识。文章主要建议内容包接受抗肿瘤坏死因子治疗括结核感染的风险,开始抗肿瘤坏死因子治疗前潜伏或活动性结核病筛查,准备抗肿瘤坏死因子治疗晚期结核感染的管理,抗肿瘤坏死因子治疗期间监测,抗肿瘤坏死因子治疗后结核感染的管理。

2017 AOCC/APAGE共识:接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险管理

2017年10月,亚洲克罗恩病和结肠炎组织(AOCC)联合亚太地区胃肠病学协会(APAGE)共同发布了接受抗肿瘤坏死因子治疗的炎症性肠病患者结核感染的风险评估和管理共识。文章主要建议内容包接受抗肿瘤坏死因子治疗括结核感染的风险,开始抗肿瘤坏死因子治疗前潜伏或活动性结核病筛查,准备抗肿瘤坏死因子治疗晚期结核感染的管理,抗肿瘤坏死因子治疗期间监测,抗肿瘤坏死因子治疗后结核感染的管理。

Frontiers in Immunology:吸烟可能导致炎症性肠病

一项新的研究首次表明了香烟烟雾对肠道炎症的直接影响。韩国的研究人员报告说,将老鼠暴露在香烟烟雾中会导致结肠炎,这是一种类似于克罗恩病的结肠炎症,并确定了一种特定的白细胞和炎症蛋白。这项研究今天发表在开放获取期刊《Frontiers in Immunology》杂志上,可以帮助科学家开发新的治疗炎症性肠病的方法,如克罗恩病,并提高吸烟者对结肠炎风险的认识。之前的研究表明,吸烟会显着增加克罗恩病的风险

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