Prenatal Regeneration in Clinical Practice.
Prenatal Regeneration in Clinical Practice.
复制标题
临床实践中的产前再生。
DOI：
10.1016/j.mayocp.2018.04.004
复制
发表时间：
2018
影响因子：
8.9
通讯作者：
Waldman,ScottA
中科院分区：
文献类型：
--
作者：
Waldman,ScottA
目的了解克罗恩病（CD）和溃疡性结肠炎（UC）的死亡率及其时间变化趋势。患者和方法：1970年1月1日至2010年12月31日期间，明尼苏达州奥姆斯特德县所有895名首次诊断为炎症性肠病（IBD）的居民（411人患有乳糜泻，484人患有UC）被随访至2016年6月30日。标准化死亡率（SMRs）是通过计算得出的，预期死亡率来源于美国2010年背景人口。为了确定总体和原因特异性死亡率，每名IBD患者与5名县居民匹配，并使用Cox回归分析评估死亡时间。结果共纳入IBD患者895例，非IBD患者4475例。74例CD患者死亡，预期为59.2例（SMR, 1.25; 95% CI, 0.98-1.57）； 77例UC患者死亡，预期为108.1例（SMR, 0.71; 95% CI, 0.56-0.89）。在CD中，死亡风险与1970年至1979年的诊断显著相关（SMR, 1.90; 95% CI, 1.24-2.78）。在1980年以后确诊的患者中，乳糜泻患者的死亡风险与美国背景人群相似。UC的死亡风险在所有诊断期间都低于预期。在Cox回归分析中，与对照队列相比，CD组（风险比[HR]， 1.26; 95% CI, 0.97-1.63）或UC组（风险比[HR]， 0.89; 95% CI, 0.70-1.14）的总死亡率没有显著升高。CD患者死于消化系统疾病（HR, 3.70; 95% CI, 1.24-11.0）和呼吸系统疾病（HR, 2.72; 95% CI, 1.36-5.44）的风险增加，但UC患者没有。在这个队列中，1980年以后诊断的乳糜泻患者的总死亡率与美国背景人群没有差异。从1970年到2010年，UC患者的总死亡率低于预期死亡率。
ObjectiveTo determine the mortality of Crohn disease (CD) and ulcerative colitis (UC) and temporal trends in mortality.Patients and MethodsAll 895 residents of Olmsted County, Minnesota, first diagnosed as having inflammatory bowel disease (IBD) (411 with CD and 484 with UC) from January 1, 1970, through December 31, 2010, were followed through June 30, 2016. Standardized mortality ratios (SMRs) were computed—expected rates were derived from the US 2010 background population. To determine overall and cause-specific mortality, each patient with IBD was matched with 5 county residents, and Cox regression analysis was used to assess time to death.ResultsA total of 895 patients with IBD and 4475 patients without IBD were included. Seventy-four patients with CD died compared with 59.2 expected (SMR, 1.25; 95% CI, 0.98-1.57), and 77 patients with UC died compared with 108.1 expected (SMR, 0.71; 95% CI, 0.56-0.89). In CD, the risk of dying was significantly associated with diagnosis from 1970 through 1979 (SMR, 1.90; 95% CI, 1.24-2.78). Of those diagnosed after 1980, the risk of dying in patients with CD was similar to the US background population. In UC, the risk of dying was less than expected in all periods of diagnosis. In the Cox regression analysis, overall mortality was not significantly higher in CD (hazard ratio [HR], 1.26; 95% CI, 0.97-1.63) or UC (HR, 0.89; 95% CI, 0.70-1.14) compared with the comparison cohort. The risk of dying of digestive diseases (HR, 3.70; 95% CI, 1.24-11.0) and respiratory diseases (HR, 2.72; 95% CI, 1.36-5.44) was increased in CD but not UC.ConclusionIn this cohort, overall mortality in patients with CD diagnosed after 1980 did not differ from that in the US background population. Overall mortality in patients with UC diagnosed from 1970 through 2010 was lower than the expected mortality.