炎症性肠病患者的吸烟和结直肠瘤:剂量效果关系
Anouk M Wijnands1, Sjoerd G Elias2, Evelien Dekker3
1Department of Gastroenterology and Hepatology, University Medical Centre Utrecht, Utrecht, The Netherlands.
United European gastroenterology journal
|July 28, 2023
概括
吸烟包装年增加结肠直肠瘤的风险在炎症性肠道疾病患者. 这项研究强调了一种剂量依赖的关系,敦促对长期吸烟者进行更密切的监测.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 流行病学 流行病学
背景情况:
- 关于吸烟对结肠炎相关结肠直肠瘤 (CRN) 的影响,存在相互矛盾的证据.
- 炎症性肠病 (IBD) 患者面临CRN的风险增加.
- 了解吸烟的作用对于IBD管理和CRN预防至关重要.
研究的目的:
- 调查吸烟状态和包装年与IBD患者CRN风险之间的关联.
- 为了确定吸烟和CRN发展之间是否存在剂量反应关系.
- 澄清吸烟对IBD中CRN风险的独立贡献.
主要方法:
- 对576名IBD患者 (2011-2021) 的前性,多中心队列研究.
- 利用考克斯的比例危险模型来评估吸烟状态和包装年与反复发生的CRN事件.
- 调整了关键的混因素,包括疾病程度,先前的发育不良症和家族史.
主要成果:
- 吸烟与复发性CRN没有显著的关联 (aHR1.04).
- 增加的包装年表现出与更高的复发性CRN风险有显著的关联 (每10个包装年的aHR为1.17,p <0.05).
- 在IBD类型之间没有观察到显著差异.
结论:
- 在IBD患者的吸烟包年和复发CRN风险之间存在剂量依赖的关系.
- 吸烟强度,以包年来衡量,是IBD中CRN的独立风险因素.
- 调查结果强调了戒烟和监测在IBD管理中的重要性.
相关概念视频
Inflammatory Bowel Disease I: Ulcerative Colitis
219
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
219
Inflammatory Bowel Disease II: Crohn's Disease
296
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...
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...
296
Drugs for Treatment of Ulcerative Colitis in IBD
175
Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide...
175
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
356
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
356
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
195
Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel...
195
Inflammatory Bowel Disease IV: Pharmacological Management
154
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...
154


