活性疾患中の静脈性血栓塞栓症と炎症性腸疾患における寛解:コホート研究
Matthew J Grainge1, Joe West, Timothy R Card
1Division of Epidemiology and Public Health, University of Nottingham, Nottingham, UK. matthew.grainge@nottingham.ac.uk
Lancet (London, England)
|February 13, 2010
まとめ
炎症性腸疾患 (IBD) の患者は,特に発症時に,静脈血栓塞栓症 (VTE) のリスクが著しく高くなります. これは,IBD患者のVTE予防の必要性を強調しています.
科学分野:
- 胃腸内科 胃腸内科
- 血管医学 血管医学とは
- エピデミオロジー エピデミオロジー
背景:
- 炎症性腸疾患 (IBD) は,静脈血栓塞栓症 (VTE) のリスクの増加と関連しています.
- VTEのリスクは,IBDの活動段階によって異なります.
研究 の 目的:
- IBDの患者におけるVTEのリスクを予測的に定量化する.
- IBDの様々な活動段階においてVTEのリスクがどのように異なるかを評価する.
主な方法:
- 一般診療研究データベースを使用したコホート研究.
- IBD患者と対照群をマッチングし,時間変動の共変数によるコックス回帰分析を用いた.
- 発症を,コルチコステロイド処方後の120日間で定義する.
主要な成果:
- IBD患者には,対照群と比較して,VTEのリスクが3.4倍増加しました.
- IBDの発作の間,VTEのリスクは著しく高かった (HR 8.4).
- 発作時のVTEの相対的なリスクは,入院期間よりも入院期間の非入院期間に高かった.
結論:
- この研究は,IBD患者のVTEリスクが著しく上昇していることを示しており,特に発作中に顕著です.
- IBD患者のVTEに対するプライマリ予防試験は,予防戦略を探求するために正当化されています.
関連する概念動画
Inflammatory Bowel Disease III: Crohn's Disease
Crohn’s disease is a chronic, relapsing form of inflammatory bowel disease characterized by segmental, transmural inflammation that can affect any part of the gastrointestinal tract. Its pathogenesis arises from a combination of genetic susceptibility, environmental exposures, epithelial barrier dysfunction, and immune dysregulation. Together, these factors lead to an exaggerated immune response against components of the gut microbiome.Genetic and Environmental InfluencesMultiple genetic...
Inflammatory Bowel Disease II: Crohn's Disease
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by transmural...
Inflammatory Bowel Disease IV: Clinical Manifestations
Inflammatory bowel disease (IBD) encompasses two major chronic disorders—ulcerative colitis and Crohn’s disease—each characterized by relapsing episodes of gastrointestinal inflammation. Although they share certain clinical features, their patterns of involvement and manifestations differ in ways that aid diagnosis and guide management.Ulcerative ColitisUlcerative colitis is limited to the colon and rectum and involves continuous inflammation of the mucosal layer. The disease course is marked...
Inflammatory Bowel Disease IV: Pharmacological Management
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
Inflammatory Bowel Disease II: Ulcerative Colitis
Ulcerative colitis is a chronic inflammatory disorder of the colon characterized by continuous mucosal inflammation that typically begins in the rectum and extends proximally in a uniform pattern. Its pathogenesis involves a complex interplay of genetic predisposition, immune dysregulation, and environmental influences. These factors converge to impair the colon’s epithelial defenses and promote an exaggerated inflammatory response against luminal contents.Breakdown of the Mucosal BarrierA...
Inflammatory Bowel Disease I: Introduction
Inflammatory bowel disease is a group of chronic disorders marked by recurrent inflammation of the gastrointestinal tract due to an abnormal immune response against gut microflora. This leads to tissue damage. The two main forms are Crohn’s disease and ulcerative colitis.Crohn’s DiseaseCrohn’s disease is a relapsing inflammatory disorder that can affect any part of the GI tract, from the mouth to the anus. It involves all layers of the bowel wall (transmural) and shows “skip lesions” in which...

