婴儿和非常早期发病的炎症性肠病:一个多中心研究
Anat Guz-Mark1, Marina Aloi2, Luca Scarallo3
1Institute of Gastroenterology, Nutrition and Liver Diseases, Schneider Children's Medical Center of Israel, Petach Tikva, Tel-Aviv University, Tel-Aviv, Israel.
Pediatrics
|July 17, 2024
概括
非常早期发病的炎症性肠病 (VEOIBD) 患者,包括婴儿IBD,通常具有良好的长期结果,并发症很少. 然而,单源性IBD病例表明严重疾病进展的风险更高.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 胃肠道疾病的遗传学
背景情况:
- 在6岁之前 (VEOIBD) 和2岁之前 (婴儿-IBD) 诊断的炎症性肠病 (IBD) 代表着一个独特的临床挑战.
- 了解这些年轻患者的特殊特征和长期发展轨迹对于优化管理至关重要.
研究的目的:
- 描述疾病特征并评估被诊断为VEOIBD和婴儿IBD的患者的长期结果.
- 在这个儿科群体中确定与疾病严重程度和治疗反应相关的因素.
主要方法:
- 对2008-2018年间在21个国际中心诊断的VEOIBD病例的回顾性审查.
- 纳入标准要求至少2年后续数据.
主要成果:
- 该队列包括243名患者 (52%是男性),其中69人被诊断为婴儿IBD. 克罗恩病 (CD) 影响了30%,性结肠炎 (UC) 59%,IBD未分类 (IBDU) 11%.
- 婴儿IBD患者的IBDU发病率较高,初始治疗反应较差,血红蛋白/白蛋白水平较低. 长期大肠切除术率为11%,没有显著的年龄组差异.
- 40%的患者进行了基因检测,16%的患者发现了单一性疾病,与治疗反应较低,手术增加和感染率较高有关.
结论:
- 包括婴儿IBD在内的VEOIBD与长期并发症和手术干预的发病率较低有关.
- 单一性IBD患者倾向于更严重的疾病过程和较差的治疗结果.
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