炎症性腸疾患の患者および無患者の大腸がん手術後の静脈血栓塞栓症のリスク
Gencer Kurt1, Frederikke Schønfeldt Troelsen1,2, Katalin Veres1
1Department of Clinical Epidemiology and Center for Population Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark.
The American journal of gastroenterology
|September 3, 2025
まとめ
炎症性腸疾患 (IBD) の患者は,大腸がん (CRC) の手術後に静脈血栓塞栓症 (VTE) のリスクが高くなります. この高いリスクは,特にIBDが活発な患者や,事前に治療を受けた患者で顕著であり,静脈動脈炎の管理の必要性を強調しています.
科学分野:
- 胃腸内科
- 腫瘍学
- 血管 外科
背景:
- 炎症性腸疾患 (IBD) は,大腸がん (CRC) 手術後の手術後の死亡率の増加と関連しています.
- 静脈血栓塞栓症 (VTE) は,この死亡率の増加に寄与する可能性がある.
- CRC手術を受けるVTE患者のリスクを理解することは,結果の改善に不可欠です.
研究 の 目的:
- 第1回CRC手術を受けたIBD患者と無患者のVTEのリスクを調査する.
- IBD集団の中でVTEのリスクが高い特定の患者のサブグループを特定する.
主な方法:
- 1996年から2021年にかけてのデンマークの健康登録を利用した集団ベースのコホート研究.
- 第一次CRC手術を受けた患者83,950人を含む.
- 365日間の累積VTEリスクの計算と調整された危険比率 (aHR) のコックス回帰分析.
主要な成果:
- 30日間のVTEリスクはIBD患者では1. 5%であり,IBDでない患者では0. 7%であった (aHR1. 61).
- 60~69歳の男性,IBDの治療を受けた患者,および病気の進行中の患者 (aHRは1. 95から5. 29) の間で高かった.
- 関連性は主に潰瘍性大腸炎 (UC) 患者によって引き起こされ,手術後365日までの持続的なリスクが高まりました.
結論:
- IBDの患者は,CRC手術後のVTEのリスクが増加しています.
- 手術前のIBD治療と,特にUC患者における,活発な疾患状態は,最も高いVTEリスクと関連しています.
- CRC手術を受ける高リスクIBD患者には,強化されたVTE監視と最適化されたIBD疾患制御が推奨されます.
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