炎症性肠病患者的组织学缓解和死亡率:全国性队列研究
Jiangwei Sun1, Karl Mårild2, David Bergman1
1Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
概括
炎症性肠病 (IBD) 活动,包括组织学和临床,显著增加2年死亡风险. 在IBD患者中更好地控制疾病可能会降低这种风险.
科学领域:
- 胃肠病学 胃肠病学
- 临床流行病学临床流行病学
- 公共卫生 公共卫生
背景情况:
- 炎症性肠病 (IBD) 与高死亡率有关.
- 组织学和临床疾病活动对IBD相关死亡率的影响尚不清楚.
研究的目的:
- 调查IBD患者组织炎症和死亡率之间的关联.
- 检查IBD患者临床疾病活性和死亡率之间的关系.
- 确定改善疾病控制是否可以减轻IBD的死亡风险.
主要方法:
- 在瑞典进行全国性队列研究,包括超过63,000名IBD患者.
- 基于组织学炎症与缓解的死亡率的比较.
- 基于临床活动与静止疾病的死亡率分析.
- 用因特定危险模型估计了两年全因死亡率的调整危险比率 (aHR).
主要成果:
- 与缓解相比,组织学炎症与45%的2年死亡风险增加有关 (aHR,1.45).
- 这种增加的风险在克罗恩病,性结肠炎和IBD未分类中是一致的.
- 临床活性IBD显示2.年死亡风险增加3.35倍 (aHR,3.35) 与静止IBD相比.
- 即使是临床静止IBD与组织学炎症携带的42%更高的死亡风险 (aHR,1.42).
结论:
- 在IBD中,活跃炎症的组织学和临床标志物都与增加全因死亡率有显著的关联.
- 这些发现强调了实现和保持疾病控制的重要性,以潜在地减少IBD患者的死亡率.
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