炎症性肠病老年患者的挑战和治疗策略:系统性审查和叙述综合
John K Triantafillidis1,2, Konstantinos Malgarinos1,2, Georgia Kontrarou1,2
1IBD Unit, "METROPOLITAN GENERAL" Hospital, 264 Mesogeion Avenue, 15562 Athens, Greece.
Journal of personalized medicine
|February 26, 2026
概括
在老年人中,炎症性肠病 (IBD) 的发生率正在上升. 生物疗法对年轻患者具有相似的疗效,但由于并发症和多药性,需要谨慎管理.
科学领域:
- 胃肠病学 胃肠病学
- 老年医学 老年医学
- 药理学 药理学是指药理学的学科.
背景情况:
- 患有炎症性肠病 (IBD) 的老年人群正在增长,这带来了独特的诊断和治疗挑战.
- 免疫性,多病性和多药性使老年IBD患者的生物疗法的风险益处评估复杂化.
研究的目的:
- 系统地审查老年IBD的流行病学,临床特征和治疗管理.
- 综合有关老年IBD患者生物疗法的最新数据和指导方针,重点关注安全性和现实世界的结果.
主要方法:
- 我们对PubMed,Scopus和Embase进行了系统的文献搜索.
- 包括40项研究 (RCT,前性,回顾性队列) 并对人口统计数据,疾病表型,并发症和治疗结果进行了叙事综合.
- 使用纽卡斯尔-太华尺度和柯克兰偏差风险工具评估偏差风险.
主要成果:
- 在老年人中,IBD的发病率正在增加,通常与较轻的疾病和较高的UC:CD比率有关.
- 生物药物 (抗TNF,维多利祖马布,乌斯特基努马布) 的疗效与年轻患者的疗效相比,具有良好的安全性,但JAK抑制剂具有血栓栓塞的风险.
- 年龄较大与严重感染,住院和死亡率较高相关,需要个性化护理,脆弱性评估和感染控制.
结论:
- 老年人的IBD是一个独特的临床实体,需要多学科的方法和个性化的治疗策略.
- 将疾病控制与管理并发症和多药性风险之间的平衡对于最佳护理至关重要.
- 需要进一步的研究,包括专门的临床试验,以完善治疗和改善这一群体的结果.
相关概念视频
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
972
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...
972
01:29Inflammatory Bowel Disease IV: Pharmacological Management
852
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...
852
01:21Inflammatory Bowel Disease V: Surgical Management
769
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
769
01:17Chronic Bowel Disorders: Introduction
849
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
849
01:30Irritable Bowel Syndrome III: Medical and Nursing Management
938
Managing Irritable Bowel Syndrome (IBS) involves a multifaceted approach, including lifestyle modifications, dietary changes, and medication.
938
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
1.3K
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...
1.3K