口服避孕药的使用与克罗恩病的临床病程：一项前瞻性队列研究。
Oral contraceptive use and the clinical course of Crohn's disease: a prospective cohort study.
作者信息
Cosnes J, Carbonnel F, Carrat F, Beaugerie L, Gendre J P
机构信息
Service d'Hépatogastroentéro-logie et Nutrition, Hôpital Rothschild, Paris, France.
出版信息
Gut. 1999 Aug;45(2):218-22. doi: 10.1136/gut.45.2.218.
BACKGROUND
Women with Crohn's disease are usually advised not to take oral contraceptives, but, unlike smoking, there is no clear association between current oral contraceptive use and more severe disease.
AIM
To assess the effect of oral contraceptive use on the clinical course of Crohn's disease.
PATIENTS
331 women, aged 16-50 years, with Crohn's disease and Crohn's disease activity index <200, were enrolled consecutively during a one year period. Patients were classified at inclusion as oral contraceptive users or non-users and smokers or non-smokers.
METHODS
A prospective 12-18 month cohort study was used. The main outcome measures were flare up rate and time to flare up.
RESULTS
In total, 134 women used oral contraceptives, in most cases low oestrogen formulations. During the study period, 61 oral contraceptive users (46%) developed a flare up, compared with 85 non-users (43%). The hazard ratio for oral contraceptive use was 1.11 (95% confidence interval 0.80 to 1.55). Variables associated with flare up were smoking status, recently active disease, baseline Crohn's disease activity index, and presence of anoperineal lesions. The same results were obtained when the analysis was restricted to patients eligible for a relapse prevention trial.
CONCLUSION
Unlike smoking, oral contraceptives have no effect on Crohn's disease activity.
背景
通常建议患有克罗恩病的女性不要口服避孕药，但是，与吸烟不同，目前口服避孕药的使用与病情加重之间并无明确关联。
目的
评估口服避孕药对克罗恩病临床病程的影响。
患者
在一年期间，连续纳入了331名年龄在16至50岁之间、患有克罗恩病且克罗恩病活动指数<200的女性。患者在纳入时被分为口服避孕药使用者或非使用者以及吸烟者或非吸烟者。
方法
采用前瞻性队列研究，为期12 - 18个月。主要观察指标为病情复发率和复发时间。
结果
共有134名女性使用口服避孕药，多数情况下使用低雌激素制剂。在研究期间，61名口服避孕药使用者（46%）病情复发，相比之下，85名非使用者病情复发率为43%。口服避孕药使用的风险比为1.11（95%置信区间0.80至1.55）。与病情复发相关的变量包括吸烟状况、近期疾病活动、基线克罗恩病活动指数以及有无肛门直肠病变。当分析仅限于符合复发预防试验条件的患者时，得到了相同的结果。
结论
与吸烟不同，口服避孕药对克罗恩病活动没有影响。
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