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Semin Arthritis Rheu:炎症性肠病患者外周附着点炎和关节炎的超声检查及临床评估

2020-01-13 xiangting MedSci原创

IBD患者经常出现肌肉骨骼症状。在无症状患者中也观察到了超声附着点和关节受累。

这项研究旨在评估意大利炎症性肠病患者(IBD临床和超声检查发现肌肉骨骼受累的患病率。

在这项横断面多中心研究中,一位肠科医师和风湿病医师对148例连续性IBD患者进行评估。所有患者均接受6对附着点和膝关节、踝关节的B型和功率多普勒超声检查。

40.5%的患者报告有至少一种肌肉骨骼表现的阳性病史,溃疡性结肠炎患者(UC)中更常见(p=0.033)。13.5%的患者报告有炎性背痛,14.9%既往有外周关节炎病史,14.2%有附着点炎症,2.7%有指炎。在临床检查中,发现19.6%的患者有关节炎,而33%的患者有附着点炎。在临床检查中,与克罗恩病CD)相比,UC患者的寡关节炎和附着点炎更常见。37.8%的IBD患者符合中轴型和/或外周脊椎关节炎的ASAS分类标准,其中8.1%符合中轴型脊椎关节炎的ASAS分类标准,29.7%符合外周脊椎关节炎的ASAS分类标准。超声检查时,在87.8%的患者中观察到附着点受累迹象,而功率多普勒检查,在27.1%的患者中观察到≥1个异常。与ASAS-患者相比,ASAS+患者超声检查中急性附着点异常、功率多普勒附着点阳性和关节受累更常见。在超声检查中,在34%、13%和12%的ASAS-患者中也观察到了这些异常。

IBD患者经常出现肌肉骨骼症状。在无症状患者中也观察到了超声附着点和关节受累。

原始出处:

Elena Bertolini. ULTRASONOGRAPHIC AND CLINICAL ASSESSMENT OF PERIPHERAL ENTHESITIS AND ARTHRITIS IN AN ITALIAN COHORT OF INFLAMMATORY BOWEL DISEASE PATIENTS. Semin Arthritis Rheu. January 2020.

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    2020-01-15 lmm397
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    2020-01-15 zhaojie88
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炎症性肠病妊娠期管理的专家共识意见

炎症性肠病大多于中青年发病,会面临生育问题,故加强妊娠前咨询、优化妊娠期管理可改善不良妊娠结局,提高患者生命质量。本共识基于循证医学依据和Delphi 方法,在妊娠前指导和管理、妊娠期管理、分娩方式、哺乳期管理和婴儿疫苗接种共5 个方面达成初步共识,为临床工作提供指导。

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