来自脆弱地区的儿科炎性肠病患者的缓解延迟,住院人数增加
Bradley Anding1, Elizabeth Baker2, Gabriela R Oates3
1Department of Pediatrics, Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Journal of pediatric gastroenterology and nutrition
|November 18, 2025
概括
社会脆弱性与儿科炎性肠病 (IBD) 的更糟糕结果有关. 在高脆弱性地区的患者在IBD诊断后的第一年面临更多的住院治疗和延迟缓解.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 公共卫生 公共卫生
- 健康差异 在健康上的差异
背景情况:
- 儿童炎症性肠病 (IBD) 的发病率在全球范围内正在上升.
- 遗传和环境因素有助于IBD病因.
- 健康的社会决定因素 (SDoH) 显著影响慢性疾病的结果.
研究的目的:
- 评估SDoH和儿科IBD之间的关联.
- 为了确定居住在社会脆弱地区是否与诊断后第一年的更糟糕结果相关.
主要方法:
- 对222名儿科IBD患者 (2018-2022) 的回顾性队列研究.
- 利用社会脆弱性指数 (SVI) 来评估社区层面的社会经济脆弱性.
- 主要结局包括诊断时的住院,第一年住院和6个月和1年的疾病活动.
主要成果:
- 在最脆弱的四分位数 (前25%的SVI) 中的患者在诊断时 (aOR 2.51) 和第一年 (aOR 3.44) 中住院的几率更高.
- 较高的SVI与6个月后活跃疾病的可能性增加有关 (OR 2.47).
- 根据邻里社会经济脆弱性,在1年内没有观察到活跃疾病的显著差异.
结论:
- 社会脆弱性是儿科IBD的一个重要因素,增加住院的风险,并在第一年内推迟缓解.
- 在诊断时对SDoH进行查对于识别有风险的儿科IBD患者至关重要.
- 以SDoH查为指导的有针对性的干预措施可以帮助预防不良疾病结果.
相关概念视频
Inflammatory Bowel Disease II: Crohn's Disease
932
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
932
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption
232
Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
232
Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
620
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
620
Inflammatory Bowel Disease IV: Pharmacological Management
452
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
452
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids
417
Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2...
417
Inflammatory Bowel Disease I: Ulcerative Colitis
876
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
876


