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克罗恩氏病的复发率和疾病复发:一个基于人群的研究,使用个人级别的患者数据
Anja Poulsen1,2, Julie Rasmussen3, Mads Damsgaard Wewer4,5
1Digestive Disease Center, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
Journal of Crohn's & colitis
|May 10, 2024
概括
经过肠切除的克罗恩氏病患者有显著的再切除率,受疾病活性和表型的影响. 早期的生物疗法在降低特定克罗恩病亚组的复发风险方面显示出有前途.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床流行病学 临床流行病学
背景情况:
- 克罗恩氏病 (CD) 管理通常需要肠切除,尽管医学的进步.
- 切除后的复发和重新切除仍然是CD患者面临的重大挑战.
研究的目的:
- 为了确定克罗恩病患者当代的再切割率.
- 确定影响再切割和疾病修饰的因素.
主要方法:
- 基于人口的回顾性队列研究,对631名接受初级切除的丹麦CD患者进行了回顾性队列研究 (2010-2020).
- 个体患者级数据分析,以评估再切割率和风险因素.
主要成果:
- 24.5%的患者进行了第二次切除,5.3%进行了第三次切除;1,5年和10年的再切除率分别为12.6%,22.4%和32.2%.
- 疾病活动和胃口逆转是重新切割的主要原因.
- 早期的生物治疗 (1年内) 降低了狭窄/透表型的复发风险 (HR 0.58).
- 风险因素包括切除的片段位置,疾病位置/行为,吸烟和围疾病.
结论:
- 重复切割率低于之前报告的,并且与CD表型和位置有关.
- 在切除后一年内开始的生物治疗可能会改变特定CD患者亚组的疾病进程.
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