Abdominal pain in quiescent inflammatory bowel disease.
Abdominal pain in quiescent inflammatory bowel disease.
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DOI：
10.1007/s00384-020-03727-3
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发表时间：
2021-01
影响因子：
2.8
通讯作者：
Clarke K
中科院分区：
文献类型：
--
作者：
Coates MD;Johri A;Gorrepati VS;Maheshwari P;Dalessio S;Walter V;Stuart A;Koltun W;Bernasko N;Tinsley A;Williams ED;Clarke K
炎症是炎症性肠病(IBD)腹痛的重要驱动因素。然而，一些缓解期的患者仍然感受到疼痛。我们的目的是确定与静止期IBD腹痛(QP-IBD)相关的危险因素，并区分与活动期疼痛(AP-IBD)患者的不同之处。我们利用本机构IBD自然病史登记处(1/1/15-8/31/18)的数据进行了回顾性分析。由参与者完成内窥镜评估、同步实验室研究和验证性调查。人口统计学和临床数据也被提取出来。我们招募了122例静止期疾病患者(65例女性：57例；93例CD：26例UC：3例不明原因)，74例(60.7%)患有QP-IBD。QP-IBD患者更容易出现焦虑/抑郁(71.6%对25.0%，p<；0.001)或使用抗抑郁药(47.3%对22.9%，p<；0.010)、阿片类药物(18.9%对2.1%，p<；0.010)、其他止痛药(50.0%对18.8%，p<；0.010)或皮质类固醇(18.9%对2.1%，p<；0.010)。Logistic回归分析显示，激素使用、焦虑/抑郁状态和女性分别与QP-IBD(P<；0.050或更低)独立相关。与AP-IBD患者(n=110，59F：51M；69CD：38UC：3未定)相比，QP-IBD患者更有可能使用抗抑郁药物(45.6%vs.26.4%，p<；0.010)。血小板、白细胞、C反应蛋白和沉降率水平在QP-IBD(均为P<；0.050)中升高的可能性较小，尽管44%的患者至少有一项表现为病理性升高。QP-IBD与糖皮质激素的使用、焦虑/抑郁和女性独立相关。与AP-IBD相比，QP-IBD患者更有可能使用抗抑郁药物，而不太可能表现出炎症标志物的升高。然而，许多QP-IBD患者仍然表现出这些测试的病理性升高，表明有必要为这种情况开发新的非侵入性筛查方法。
Inflammation is an important driver of abdominal pain in inflammatory bowel disease (IBD). However, some patients in remission still experience pain. We aimed to identify risk factors associated with abdominal pain in quiescent IBD (QP-IBD), and to characterize differences from patients with active disease experiencing pain (AP-IBD). We performed a retrospective analysis utilizing data from our institution’s IBD Natural History Registry (1/1/15–8/31/18). Endoscopic evaluation, concurrent laboratory studies and validated surveys were completed by participants. Demographic and clinical data were also abstracted. We recruited 122 patients with quiescent disease (65f:57m; 93CD:26UC:3Indeterminate) for participation in this study, 74(60.7%) had QP-IBD. QP-IBD patients were more likely to have anxiety/depression (71.6%vs.25.0%, p<0.001) or to use antidepressants (47.3%vs.22.9%, p<0.010), opiates (18.9%vs.2.1%, p<0.010), other pain medications (50.0%vs.18.8%%, p<0.010) or corticosteroids (18.9%vs.2.1%%, p<0.010). On logistic regression analysis, corticosteroid use, anxious/depressed state and female gender were each independently associated with QP-IBD (p<0.050 or less). Compared to AP-IBD patients (n=110, 59f:51m; 69CD:38UC:3Indeterminate), QP-IBD patients were more likely to use antidepressants (45.6%vs.26.4%, p<0.010). Platelet, white blood cell, C-reactive protein and sedimentation rate levels were all less likely to be elevated in QP-IBD (all p<0.050), though 44% exhibited pathological elevation in at least one. QP-IBD was independently associated with corticosteroid use, anxiety/depression and female gender. Compared to AP-IBD, QP-IBD patients were more likely to use anti-depressants and less likely to exhibit elevated inflammatory markers. However, many QP-IBD patients still demonstrated pathological elevation of these tests, demonstrating the need to develop new non-invasive screening methods for this condition.
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影响因子：
2.9
作者：
Long MD;Kappelman MD;Martin CF;Chen W;Anton K;Sandler RS
通讯作者：
Sandler RS
影响因子：
29.4
作者：
Kappelman, Michael D.;Rifas-Shiman, Sheryl L.;Porter, Carol Q.;Ollendorf, Daniel A.;Sandler, Robert S.;Galanko, Joseph A.;Finkelstein, Jonathan A.
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