J Rheumatol:伴关节炎和关节痛的儿童炎症性肠病的表型特征和长期预后

2017-09-11 xiangting MedSci原创

诊断时有关节痛是UC结肠切除术的预测指标,也是随访期间出现关节炎的危险因素。

伴关节受累的儿童炎症性肠病IBD)的自然病程尚未得到明确描述。因此这项研究旨在探讨这种独特关联的表型特征和临床预后。

回顾性分析了2000年至2016年儿童IBD患者的病历资料。主要结局的评价包括到首次急性发作、住院、手术和生物治疗的时间。

301例克罗恩病患者中(中位年龄14.2岁),37例(12.3%)有关节炎,44例(14.6%)在诊断时有关节痛。关节炎和关节痛在女性中更常见(p = 0.028)。伴关节炎和关节痛的患者肛周疾病发生率较低(2.7%和4.5% vs.16.9%,p = 0.013),而伴关节炎患者更有可能使用生物治疗方法(HR 2.05,95%CI 1.27-3.33, p = 0.009)。129例溃疡性结肠炎患者(UC;中位年龄13.7岁),3例(2.3%)伴关节炎,16例(12.4%)诊断时伴关节痛。与没有关节受累的患者相比,伴关节痛的患者更多地使用皮质类固醇(p = 0.03)或免疫调节剂治疗(p = 0.003)。伴关节痛患者接受结肠切除术的可能性明显升高(HR 2.9,95%CI 1.1-7.4,p = 0.04)。随访期间(中位数9.0年),13例患者出现关节炎(3.3%)。诊断时的关节痛是随访期间发展为关节炎的重要预测指标(HR 9.0,95%CI 2.86-28.5,p <0.001)。

伴关节炎的儿童IBD患者具有不同的表型特征。诊断时有关节痛是UC结肠切除术的预测指标,也是随访期间出现关节炎的危险因素。

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    2017-09-13 lmm397
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    2017-09-13 tastas
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    2017-09-11 中医痴

    不错的.学习了.谢谢分享!

    0

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