性结肠炎中结肠直肠狭窄的危险因素和长期预后
Yu-Pei Shao1, Tao-Tao Han1, Hong Lv1
1Department of Gastroenterology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing 100730, China.
World journal of gastroenterology
|September 11, 2025
概括
性结肠炎 (UC) 的紧缩增加了并发症,手术和恶性瘤的风险. 建议在40岁以上或有肠外症状的UC患者进行早期监测和生物治疗.
科学领域:
- 胃肠病学 胃肠病学
- 结肠直肠手术 结肠直肠手术
- 炎症性肠道疾病研究研究
背景情况:
- 结肠直肠狭窄在性结肠炎 (UC) 中不常见,但与恶性瘤和并发症风险增加有关.
- 在UC中纤维化和狭窄发育的研究不足.
- 了解缩发生率和风险因素对于UC患者管理至关重要.
研究的目的:
- 确定大规模UC患者队列中的结直肠狭窄的发病率和长期预后.
- 确定与UC狭窄形成相关的关键风险因素.
- 分析狭窄症对患者结局的影响,包括并发症,手术和死亡率.
主要方法:
- 从2014年到2024年,对938名住院UC患者进行了回顾性分析.
- 狭窄症被定义为固定,局部化的结直肠光线缩小.
- 多变量考克斯回归确定了风险因素;卡普兰-梅尔和细灰方法分析了预后.
- 敏感性分析排除了恶性狭窄,以专注于UC特定的病理生理学.
主要成果:
- 整体狭窄发生率为12.4%,十年累积概率为11.3%.
- 患有狭窄的UC患者面临更高的肠道并发症,手术 (37.6%的10年概率) 和恶性瘤 (8.6%的病例) 的风险.
- 诊断时年龄≥40岁,肠外表现增加了收缩风险,而使用vedolizumab显示有保护作用.
结论:
- 性结肠炎患者患有结直肠狭窄体验较差的长期结果.
- 考虑早期内镜监测40岁或以上的UC患者.
- 对于高风险的UC患者,建议进行生物治疗和监测肠外表现.
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