Am J Gastroenterol:炎症性肠病患者接受长期激素治疗导致死亡风险增加

2018-01-21 zhangfan MedSci原创

研究发现对于克罗恩病患者,接受抗TNF治疗相比于激素治疗可降低死亡、心血管事件以及骨折风险

克罗恩病(CD)和溃疡性结肠炎(UC)等炎症性肠病(IBD)严重影响患者生活质量病,导致死亡率增加。近日研究人员比较了长期皮质类固醇vs抗TNF药物对IBD患者死亡率的影响。

研究对2001-13年间IBD患者药物处方进行回顾,超过3000mg的皮质类固醇类药物以及抗TNF药物处方纳入本次研究。研究的主要终点为全因死亡率,次要终点为特异性死亡率。

CD患者中,7694人接受激素治疗,1879人接受抗TNF治疗;UC患中,3224人接受激素治疗,459人接受抗TNF治疗。接受抗TNF治疗的CD患者其死亡风险显著降低(21.4 vs 30.1每1000患者年,OR 0.78, 0.65–0.93),但在UC患者中不显著 (23.0 vs. 30.9每1000患者年, OR 0.87, 0.63–1.22)。对于CD患者,抗TNF治疗可降低主要心血管事件(OR 0.68, 0.55–0.85)和髋骨折(OR 0.54, 0.34–0.83)的发生率。

研究发现对于克罗恩病患者,接受抗TNF治疗相比于激素治疗可降低死亡、心血管事件以及骨折风险。

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    2019-01-02 许安
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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Fri Jan 26 09:31:03 CST 2018, time=2018-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281855, encodeId=a6d828185501, content=你是个生生世世还是生活, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Thu Jan 25 08:03:29 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281503, encodeId=3bef2815038b, content=nzjjzhsvbsbsbsbbsb, 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channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-28 zt123

    vgdgjhvvvvvcc

    0

  5. 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channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-27 zt123

    季候风发挥更大的很好

    0

  6. 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channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-26 zt123

    恧vvvvnnnbbb

    0

  7. 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beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Wed Jan 24 08:48:54 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281245, encodeId=12542812457c, content=噢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Tue Jan 23 11:17:16 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281221, encodeId=c63e28122150, content=bbvcvnmbvbbb, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-25 zt123

    你是个生生世世还是生活

    0

  8. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Fri Jan 26 09:31:03 CST 2018, time=2018-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281855, encodeId=a6d828185501, content=你是个生生世世还是生活, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Thu Jan 25 08:03:29 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281503, encodeId=3bef2815038b, content=nzjjzhsvbsbsbsbbsb, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Wed Jan 24 08:48:54 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281245, encodeId=12542812457c, content=噢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Tue Jan 23 11:17:16 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281221, encodeId=c63e28122150, content=bbvcvnmbvbbb, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-24 zt123

    nzjjzhsvbsbsbsbbsb

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1711347, encodeId=1eea1e11347f2, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Wed Oct 31 08:15:00 CST 2018, time=2018-10-31, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064301, encodeId=24b4206430122, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Fri Jan 26 09:31:03 CST 2018, time=2018-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281855, encodeId=a6d828185501, content=你是个生生世世还是生活, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Thu Jan 25 08:03:29 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281503, encodeId=3bef2815038b, content=nzjjzhsvbsbsbsbbsb, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Wed Jan 24 08:48:54 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281245, encodeId=12542812457c, content=噢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Tue Jan 23 11:17:16 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281221, encodeId=c63e28122150, content=bbvcvnmbvbbb, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-23 smartxiuxiu

    噢?

    0

  10. 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topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Fri Jan 26 09:31:03 CST 2018, time=2018-01-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281855, encodeId=a6d828185501, content=你是个生生世世还是生活, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Thu Jan 25 08:03:29 CST 2018, time=2018-01-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281503, encodeId=3bef2815038b, content=nzjjzhsvbsbsbsbbsb, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Wed Jan 24 08:48:54 CST 2018, time=2018-01-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281245, encodeId=12542812457c, content=噢?, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=18741984753, createdName=smartxiuxiu, createdTime=Tue Jan 23 11:17:16 CST 2018, time=2018-01-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=281221, encodeId=c63e28122150, content=bbvcvnmbvbbb, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/PiajxSqBRaEKXpC8j9TaoCpG4yIB3skibUZ0ricmVQ6KKIVpqYQxINrmlibsPZSia7GOUupzuINf8UITMib8awsjjkPw/0, createdBy=abbf1713451, createdName=zt123, createdTime=Tue Jan 23 09:02:50 CST 2018, time=2018-01-23, status=1, ipAttribution=)]
    2018-01-23 zt123

    bbvcvnmbvbbb

    0

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研究发现,孕期而非婴儿期抗生素暴露会增加新生儿极早发性炎症性肠病风险,孕期微生物种群变化可能是主要的影响因素

Nat Commun:寄生虫中发现的蛋白质带来炎症性肠病新疗法

蠕虫寄生虫中的一种蛋白质有望带来炎症性肠道疾病的全新治疗方案,这种蛋白质可以避免目前免疫抑制剂药物带来的严重副作用。研究结果发表在《自然通讯》杂志上,这项研究表明,一种独特全新蠕虫蛋白,模仿人体中发现的一种细胞因子,称为转化生长因子β。

Am J Gastroenterol:炎症性肠病治疗方案的辅助决策

生物疗法的用药决策是高度个体化的,人口统计学和疾病特征对治疗决策的影响十分有限,每一个炎症性肠病患者的特征均十分显著,难以进行统计分类