性结肠炎缓解症状:对焦虑的反应还是持续的炎症?
Andrea Silva1, Maria José Temido1, Joana Madeira2
1Gastroenterology, Centro Hospitalar e Universitário de Coimbra, Portugal.
Revista espanola de enfermedades digestivas
|September 5, 2024
概括
刺激性肠综合征 (IBS) 类症状在性结肠炎 (UC) 患者中常见,并且与焦虑和亚临床炎症有关. 针对炎症和心理因素的综合方法对于管理这些患者至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 精神病体医学是一种精神病体医学.
背景情况:
- 在缓解期的炎症性肠病 (IBD) 患者中理解胃肠道症状是复杂的.
- 患有IBD的患者经常经历高度焦虑,可能会影响疾病的发展.
- 亚临床炎症可能导致这些症状.
研究的目的:
- 为了确定性结肠炎 (UC) 患者在临床缓解中出现刺激性肠综合征 (IBS) 类症状和焦虑的患病率.
- 研究IBS类症状,焦虑和亚临床炎症标志物之间的关联.
主要方法:
- 一项基于问卷的研究,包括106名UC患者,预计在2020年1月至2021年12月期间进行结肠镜检查.
- 临床缓解是由便频率,UC活性指数和C反应蛋白定义的.
- 使用罗马四号标准评估IBS诊断;通过便calprotectin (FC),梅奥内镜评分 (MES) 和Geboes评分 (GS) 评估的亚临床炎症.
主要成果:
- 27.4%的UC患者符合IBS的罗马IV标准.
- 患有UC和IBS类症状的患者表现出明显更高的便calprotectin升高率 (>100mg/Kg),MES≥1,以及Geboes得分>2.2.
- 在UC+IBS组中观察到更高的焦虑率 (51.7%对23.4%).
- 多变量分析确定高FC,组织学活性和更高的焦虑作为IBS类症状的显著预测因素.
结论:
- 在临床缓解期的UC患者中,IBS类症状很普遍.
- 这些症状与亚临床炎症和焦虑有关.
- 建议采用整体的管理策略,解决UC患者的炎症和心理方面的问题.
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