D'Incà R, Podswiadek M, Ferronato A, Punzi L, Salvagnini M, Sturniolo G C
Department of Surgical and Gastroenterological Sciences, University of Padua, Italy.
Dig Liver Dis. 2009 Aug;41(8):565-9. doi: 10.1016/j.dld.2009.01.013. Epub 2009 Mar 10.
Rheumatic manifestations are frequent in inflammatory bowel disease (IBD) and are associated with a wide range of clinical patterns.
Articular symptoms and signs were investigated by questionnaire in a cohort of 651 pts, mean age 42+/-14 years, followed at two referral hospitals over a 12-month period.
142 ulcerative colitis (UC) and 120 Crohn's disease (CD) patients referred articular pain during their IBD history: in 46% this was associated with active IBD, in 56% symptoms were intermittent and in 19% symptoms preceded IBD diagnosis. 62 pts (28 UC, 34 CD) complaining of articular symptoms at the time of the interview, were investigated by the rheumatologist: arthropathy was axial in 52%, oligoarticular in 16% and polyarticular in 23%. Oligoarthritis commonly involved the lower limbs and was more commonly associated with UC. The mean number of small joints involved was significantly higher in CD than in UC pts (9.9+/-8.2 vs. 5.6+/-4.3; p<0.01). Bone scintigraphy was abnormal in 70% of pts.
Prevalence of self-reported articular symptoms in IBD patients exceeds 40% with 9.5% incidence during 1-year follow up. Symptoms predict entheropatic involvement of the locomotor system.
风湿性表现常见于炎症性肠病（IBD），且与多种临床模式相关。
通过问卷调查对651例患者（平均年龄42±14岁）的关节症状和体征进行了调查，这些患者在两家转诊医院接受了为期12个月的随访。
142例溃疡性结肠炎（UC）患者和120例克罗恩病（CD）患者在IBD病程中出现关节疼痛：其中46%与IBD活动期相关，56%症状为间歇性，19%症状出现在IBD诊断之前。62例（28例UC，34例CD）在访谈时主诉关节症状的患者由风湿病学家进行了检查：关节病以中轴关节受累为主的占52%，少关节受累的占16%，多关节受累的占23%。少关节炎通常累及下肢，且更常见于UC患者。CD患者受累小关节的平均数量显著高于UC患者（9.9±8.2对5.6±4.3；p<0.01）。70%的患者骨闪烁显像异常。
IBD患者自我报告的关节症状患病率超过40%，1年随访期间发病率为9.5%。这些症状提示运动系统存在肠病性受累。
