Vijverman A, Piront P, Belaiche J, Louis E
Department of gastroenterology, CHU of Liège, Belgium.
Acta Gastroenterol Belg. 2006 Jan-Mar;69(1):1-4.
Anemia has been considered as an overlooked complication of inflammatory bowel disease. Studies dating back to the 80ties and the 90ties have shown 30% of anemia among inflammatory bowel disease (IBD) patients. More recently, the broader use of immunosuppressive drug and infliximab allowing better mucosal healing as well as a more aggressive treatment of anemia, including the use of safer form of IV iron, may have influenced the prevalence of anemia among IBD patients. Our aim was to asses the prevalence and characteristics of anemia among two cohorts of IBD patients at 10 years interval and to look for associated clinical or demographic factors.
Using the IBD patients register of one senior gastroenterologist, we identified IBD patients he had consecutively seen and who had blood test at the outpatient clinic during the years 1993 and 2003. Demographic and clinical characteristics, treatment for Crohn's disease, blood test results and treatment of anemia were recorded and compared between these two cohorts. Anemia was defined as an hemoglobin level lower than the normal value of the laboratory of our hospital.
80 and 90 patients were identified in 1993 and 2003, respectively. There was no significant difference between the two cohorts, according to age, gender, disease type, duration or location. There were 27/80 (33.8%) and 15/90 (16.7%) anemic patients in 1993 and 2003, respectively (P = 0.013). The prevalence of severe anemia (hemoglobin level < 10.5 g/100 ml) was similar in the two cohorts (6.3% and 5.6%). Characteristics of the anemia were similar in the two cohorts with a majority of iron deficiency anemia and inflammatory anemia. Ferritin and CRP levels were not significantly different in the two cohorts. The only significant difference was a more frequent use of immunosuppressive treatment and infliximab in 2003 than in 1993 (33.3% vs. 13.8% ; P = 0.0038, RR: 0.41, 0.22-0.77)
Prevalence of mild to moderate anemia has significantly decreased in our population over the last 10 years. The only difference detected between the two cohorts was the increased use of immunosuppressive drug (mainly azathioprine).
贫血一直被认为是炎症性肠病被忽视的并发症。可追溯到20世纪80年代和90年代的研究表明，炎症性肠病（IBD）患者中有30%存在贫血。最近，免疫抑制药物和英夫利昔单抗的更广泛使用使黏膜愈合更好，以及对贫血更积极的治疗，包括使用更安全形式的静脉铁剂，可能影响了IBD患者中贫血的患病率。我们的目的是评估间隔10年的两组IBD患者中贫血的患病率和特征，并寻找相关的临床或人口统计学因素。
利用一位资深胃肠病学家的IBD患者登记册，我们确定了他在1993年和2003年期间在门诊连续诊治并进行过血液检查的IBD患者。记录并比较这两组患者的人口统计学和临床特征、克罗恩病的治疗情况、血液检查结果以及贫血的治疗情况。贫血定义为血红蛋白水平低于我院实验室的正常值。
1993年和2003年分别确定了80例和90例患者。两组在年龄、性别、疾病类型、病程或病变部位方面无显著差异。1993年和2003年分别有27/80（33.8%）和15/90（16.7%）例贫血患者（P = 0.013）。两组中重度贫血（血红蛋白水平<10.5 g/100 ml）的患病率相似（6.3%和5.6%）。两组贫血的特征相似，大多数为缺铁性贫血和炎症性贫血。两组的铁蛋白和CRP水平无显著差异。唯一的显著差异是2003年比1993年更频繁地使用免疫抑制治疗和英夫利昔单抗（33.3%对13.8%；P = 0.0038，RR：0.41，0.22 - 0.77）
在过去10年中，我们研究人群中轻至中度贫血的患病率显著下降。两组之间唯一检测到的差异是免疫抑制药物（主要是硫唑嘌呤）使用的增加。
