轻度内镜疾病活动与老年人炎症性肠病的不良结果有关
Catherine Z Tang1, Olivia R Delau2, Seymour Katz2
1Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA.
Alimentary pharmacology & therapeutics
|October 15, 2025
概括
在患有炎症性肠病 (IBD) 的老年人中实现内镜缓解至关重要. 轻度内镜性疾病活动,与缓解不同,显著增加IBD特异性和患病率相关不良结果的风险.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 患有炎症性肠病 (IBD) 和轻度持久性疾病活动的老年人通常从实现内镜缓解中获得未知的好处.
- 目前对内镜缓解在这个特定的人群中的优势的理解仍然有限.
研究的目的:
- 调查在老年人 (≥60岁) 患有IBD和轻度或无内镜性疾病活动时实现内镜性缓解的好处.
- 为了比较内镜缓解和轻度内镜疾病患者之间IBD特异性和与发病率相关的不良结果的发生率.
主要方法:
- 从2018年1月到2023年1月,对504名IBD成年患者 (≥60岁) 的回顾性分析.
- 主要结局:1年内主要IBD特异性不良事件的组合 (住院治疗,手术,皮质类固醇处方).
- 二级结局:由1年的患病相关事件 (死亡,住院,感染,静脉动脉,心血管事件,骨折) 组成,随访5年.
主要成果:
- 在504名患者中,38.1%患有轻度内镜疾病,61.9%处于内镜缓解期.
- 与缓解相比,轻度内镜性疾病显著增加了1年IBD特定不良结果 (aOR 4.16) 和1年患病率相关不良结果 (aOR 1.56) 的几率.
- 这种IBD特异性结果的风险增加持续了5年.
结论:
- 与内镜缓解相比,老年IBD患者的轻度内镜疾病活动与短期 (1年) 和长期 (5年) 的IBD特异性结果的不良事件的风险更高.
- 在这个人群中实现内镜缓解可能会带来显著的短期和长期临床益处.
- 这些发现强调了追求内镜缓解的重要性,以改善老年IBD患者的治疗结果.
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