The Incidence and Risk Factors of Venous Thromboembolism in Patients with Inflammatory Bowel Disease: A Prospective Multicenter Cohort Study
The Incidence and Risk Factors of Venous Thromboembolism in Patients with Inflammatory Bowel Disease: A Prospective Multicenter Cohort Study
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DOI：
10.1159/000495289
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发表时间：
2019-11-01
期刊：
影响因子：
3.2
通讯作者：
Okumura, Toshikatsu
中科院分区：
文献类型：
--
作者：
Ando, Katsuyoshi;Fujiya, Mikihiro;Okumura, Toshikatsu
工作背景：在西方研究中，静脉血栓栓塞（VTE）在炎症性肠病（IBD）中比在一般人群中更常见。然而，亚洲IBD中VTE的实际状态仍然知之甚少。目的：揭示日本IBD患者中VTE的发病率。方法：从2013年到2018年，在3个胃肠病中心登记了85例患者。对IBD患者（n = 42）和其他消化系统疾病患者（n = 43）的VTE发生率进行前瞻性比较。在入院时和入院后1-2周使用对比增强计算机断层扫描和/或超声检查调查VTE的存在。比较IBD伴或不伴VTE患者的患者特征和实验室数据，以确定VTE的危险因素。结果：IBD合并VTE的发生率为16.7%，显著高于其他消化系统疾病（2.3%; p = 0.0296）。在IBD患者中，22例溃疡性结肠炎患者中有6例（27.2%）检测到VTE，但20例克罗恩病患者中仅1例（5.0%）检测到VTE。4例IBD患者入院时诊断为VTE，3例IBD患者入院后2周诊断为VTE。IBD患者发生VTE的危险因素包括留置中心静脉导管、低水平的总蛋白、低水平的活化部分凝血活酶时间和高水平的纤维蛋白原降解产物。结论：在日本IBD患者中，在入院时和入院后经常检测到VTE。在IBD中，充分筛查和预防VTE是必要的。(C)2018 S. Karger AG，巴塞尔
Background: Venous thromboembolism (VTE) has been shown to be more frequent in inflammatory bowel disease (IBD) than in the general population in Western studies. However, the actual state of VTE in Asian IBD remains poorly understood. Aims: To reveal the incidence of VTE in IBD patients in Japan. Methods: Eighty-five patients admitted to 3 gastroenterology centers were registered from 2013 to 2018. The incidence of VTE in patients with IBD (n = 42) was prospectively compared to that among patients with other digestive diseases (n = 43). The presence of VTE was surveyed using contrast-enhanced computed tomography and/or ultrasonography at admission and at 1-2 weeks after admission. The patient characteristics and laboratory data of IBD patients with or without VTE were compared to determine the risk factors for VTE. Results: The incidence of VTE with IBD was 16.7%, which was significantly more frequent than with other digestive diseases (2.3%; p = 0.0296). In IBD patients, VTE was detected in 6 of 22 patients with ulcerative colitis (27.2%) but in only 1 of 20 patients with Crohn's disease (5.0%). VTE was diagnosed at admission in 4 IBD patients and 2 weeks after admission in 3 IBD patients. The risk factors of VTE in IBD were the presence of an indwelling central venous catheter, a low level of total protein, a low activated partial thromboplastin time, and a high level of fibrinogen degradation products. Conclusion: VTE was frequently detected in Japanese IBD patients both at and after admission. Adequate screening and prophylaxis for VTE is deemed necessary in IBD. (C) 2018 S. Karger AG, Basel