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克罗恩病导致肠道衰竭的自然史:从1973年到2018年的纵向队列研究
Tian Hong Wu1, Christopher Filtenborg Brandt1, Thomas Scheike2
1Department of Intestinal Failure and Liver Diseases, Rigshospitalet, Copenhagen, Denmark.
患有克罗恩氏病的患者患有肠道衰竭,其病程更为严重,以增加住院和手术为特征. 尽管如此,他们使用生物疗法与没有肠道衰竭的人没有显著差异.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 流行病学 流行病学
背景情况:
- 克罗恩病 (CD) 导致肠衰竭 (IF) 的自然史并未得到很好的描述.
- 了解IF前的CD的临床过程和负担对于患者管理至关重要.
研究的目的:
- 描述克罗恩病在肠道衰竭之前的临床过程.
- 为了比较患有和没有IF的CD患者之间的疾病过程和负担.
主要方法:
- 使用丹麦全国范围的登记册进行的回顾性队列研究.
- 包括182名患有IF的CD患者和22,845名没有IF的CD患者.
- 通过住院,手术和药物评估疾病进程;通过就业和死亡率数据评估疾病负担.
主要成果:
- 在CD诊断后,IF的10年累积发病率随着时间的推移显著下降.
- 与没有FI的患者相比,患有FI的CD患者经历了更长的严重疾病持续时间,更高的皮质类固醇使用率,住院接触和腹部手术.
- 没有观察到生物暴露的差异,IF组的生物暴露时间较短. 在IF群体中发现死亡率增加.
结论:
- 开发IF的CD患者表现出更持久的严重的先前疾病过程.
- 尽管疾病严重,IF患者不太可能接受生物疗法,这表明治疗优化中的潜在差距.
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