Factors associated with radiation exposure in patients with inflammatory bowel disease
Factors associated with radiation exposure in patients with inflammatory bowel disease
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DOI：
10.1111/j.1365-2036.2009.04140.x
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发表时间：
2009-12-01
影响因子：
7.6
通讯作者：
Fraser, G.
中科院分区：
文献类型：
--
作者：
Levi, Z.;Fraser, A.;Fraser, G.
炎症性肠病（IBD）患者接受多项放射学评估，目的通过IBD患者的诊断X线检查估计全身和腹部放射暴露及其相关危险因素。临床数据从患者档案中提取，放射学数据从中央HMO计算机database.ResultsA共199 CD和125 UC患者。CD和UC的平均累积估计剂量（CED）分别为21.1 +/- 19.5和15.1 +/- 20.4毫西弗特（mSv）（P < 0.001）。23例患者（7.1%）的估计CED>= 50 mSv。在多变量分析中，CED增加的预测因素为：手术（OR 5.68，95%CI：2.73-11.8，P < 0.001），CD（OR 2.56，95% CI：1.29-5.07，P = 0.007），泼尼松使用（OR 2.0，95% CI：1.11-3.67，P = 0.02），疾病第1年（OR 6.4，95% CI：1.3-32，P = 0.02）和年龄在上四分位数（OR 3.26，95% CI：1.68-6.3，P = 0.001）。结论CD的诊断、IBD相关手术、强的松的使用、上四分位数的第一年诊断和年龄是IBD患者暴露增加的独立预测因素。对于有增加辐射暴露风险的患者，应考虑不需要辐射暴露的替代检查。
P>BackgroundInflammatory bowel disease (IBD) patients undergo multiple radiological evaluations.AimTo estimate total and abdominal radiation exposure from diagnostic X-ray investigations in IBD patients and the associated risk factors.MethodsPatients with Crohn's disease (CD) or ulcerative colitis (UC) treated in the IBD clinic were recruited. Clinical data were extracted from patient files and radiological data were obtained from the central HMO computer data base.ResultsA total of 199 CD and 125 UC patients were included. The mean cumulative estimated doses (CED) for CD and UC were 21.1 +/- 19.5 and 15.1 +/- 20.4 millisieverts (mSv) respectively (P < 0.001). Twenty-three patients (7.1%) had an estimated CED of >= 50 mSv. In multivariate analyses, predictors of increased CED were: surgery (OR 5.68, 95% CI: 2.73-11.8, P < 0.001), CD (OR 2.56, 95% CI: 1.29-5.07, P = 0.007), prednisone use (OR 2.0, 95% CI: 1.11-3.67, P = 0.02), first year of disease (OR 6.4, 95% CI: 1.3-32, P = 0.02) and age in the upper quartile (OR 3.26, 95% CI: 1.68-6.3, P = 0.001).ConclusionsDiagnosis of CD, IBD-related surgery, prednisone use, first year of diagnosis and age on the upper quartile are independent predictors of increased exposure in IBD patients. Alternative investigations which do not require radiation exposure should be considered for patients at risk for increased radiation exposure.