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动脉样性心血管疾病和炎症性肠道疾病:流行病学,病原和风险评估
Pierluigi Puca1, Gaetano Coppola1, Simone Parello2
1Digestive Disease Center "CeMAD", Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, 00168, Italy; Dipartimento di Medicina e Chirurgia Traslazionale, Università Cattolica del Sacro Cuore, Rome, 00168, Italy.
Best practice & research. Clinical gastroenterology
|December 5, 2025
概括
炎症性肠病 (IBD) 增加了动脉样硬化心血管疾病 (ASCVD) 的风险,特别是在活跃的炎症期间. 控制IBD炎症和传统风险因素是预防IBD患者心脏病的关键.
科学领域:
- 心血管医学 心血管医学
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
背景情况:
- 炎症性肠道疾病 (IBD) 与增加动脉样硬化心血管疾病 (ASCVD) 风险有关.
- 在年轻的患者和在活跃的疾病爆发期间,这种风险增加.
研究的目的:
- 综合有关ASCVD在IBD患者的流行病学,机制,风险分层和管理的证据.
- 了解IBD,炎症和心血管结果之间的相互作用.
主要方法:
- 对流行病学数据,元分析和机制学研究的审查.
- 对风险因素的分析,包括使用皮质类固醇,抗TNF生物药物和Janus激酶抑制剂.
- 评估拟议的驱动因素,如失生症,屏障失效和炎症途径.
主要成果:
- IBD与缺血性心脏病,脑血管事件和外围动脉疾病的风险增加有关.
- 炎症负担,爆发和皮质类固醇使用增加了ASCVD风险,而有效的IBD控制,特别是使用抗TNF药物,可能具有保护作用.
- 机制包括免疫-微生物组-屏障相互作用,血栓炎症和炎症酶激活.
结论:
- 通过复杂的免疫-微生物组-屏障相互作用和传统因素,IBD给人带来了显著的ASCVD风险.
- 综合护理包括心血管评估,炎症控制,生活方式改变和适当的治疗对于IBD患者至关重要.
- 需要进一步的研究来完善各种IBD表型的预测工具和预防策略.
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