Clinical outcomes and risk factors of secondary extraintestinal manifestation in ulcerative colitis: results of a multicenter and long-term follow-up retrospective study
Clinical outcomes and risk factors of secondary extraintestinal manifestation in ulcerative colitis: results of a multicenter and long-term follow-up retrospective study
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溃疡性结肠炎继发肠外表现的临床结局及危险因素：多中心长期随访回顾性研究结果
DOI：
10.7717/peerj.7194
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发表时间：
2019-06-21
期刊：
影响因子：
2.7
通讯作者：
Du, Peng
中科院分区：
文献类型：
--
作者：
Xu, Weimin;Ou, Weijun;Du, Peng
背景溃疡性结肠炎(UC)以肠外表现为主。在上海，中国，关于UC患者EIM发病率和危险因素的数据仍然很少。方法研究人群包括1986年6月至2018年12月期间从我们研究所前瞻性维护的机构审查委员会批准的数据库中确定的UC患者。分析了研究参与者的人口学和临床特征。这项研究包括UC患者的继发性EIM和随访，排除了原发EIM。EIM的诊断基于临床、放射学、内窥镜、免疫学检查和组织学检查。结果本研究共纳入271例符合条件的患者，中位随访时间为13.0年(四分位数范围9.0-17.0)，其中31例(11.4%)发展为EIM。肠易激综合征与UC患者的临床预后相关，下列因素被确定为易患肠梗阻的因素：病程5年(优势比(OR)，3.721；95%可信区间(CI)[1.209-11.456])，确诊年龄(OR，2.924，95%CI[1.165-7.340])，难治性临床症状(OR，4.119；95%CI[1.758-9.650])，以及中、重度贫血(OR，2.592；95%可信区间[1.047-6.413])。结论在本研究中，大约11.4%的UC患者继续发展为至少一种EIM。临床医生应重视UC的早期控制和贫血的治疗，以预防EIM的发展，改善疾病预后。
Background Extraintestinal manifestations (EIM) are common in ulcerative colitis (UC). In Shanghai, China, data on the incidence rate and risk factors of EIM in UC patients remain scarce. Methods The study population consisted of UC patients who were identified from a prospectively maintained, institutional review board-approved database at our institutes from June 1986 to December 2018. The demographic and clinical characteristics of the study participants were analyzed. The study included secondary EIM in UC patients and follow-up, while primary EIM was excluded. The diagnosis of EIM was based on clinical, radiological, endoscopic, and immunologic examination and histological findings. Results In total, 271 eligible patients were included in the current study, with a median follow-up time of 13.0 years (interquartile range, 9.0–17.0), and including 31 cases (11.4%) that developed EIM. EIM was associated with clinical outcomes in UC patients and the following factors were identified as contributing factors for the development of EIM: a disease duration of >5 years (odds ratio (OR), 3.721; 95% confidence interval (CI) [1.209–11.456]), age at diagnosis >40 years (OR, 2.924, 95% CI [1.165–7.340]), refractory clinical symptoms (OR, 4.119; 95% CI [1.758–9.650]), and moderate or severe anemia (OR, 2.592; 95% CI [1.047–6.413]). Conclusion In this study, approximately 11.4% UC patients go on to develop at least one EIM. Clinicians should prioritize early control of the disease and treatment of anemia in UC in order to prevent the development of EIM and improve disease prognosis.