Gastroenterology Practice, Minden, Germany.
J Crohns Colitis. 2013 Jun;7(5):355-68. doi: 10.1016/j.crohns.2012.02.014. Epub 2012 Apr 12.
The aim of this cross-sectional study was to establish an online inflammatory bowel disease (IBD) registry for a first picture of the situation of IBD outpatients' treatment in Germany.
Between March 2006 and July 2007 IBD outpatients from 24 gastroenterological specialist practices and two hospitals in Germany were enrolled in an Internet-based registry to evaluate the outpatients' clinical status, psychological impairments, provided health care, as well as medical treatment and medication costs.
1032 IBD patients (ulcerative colitis/UC: 519; Crohn's disease/CD: 511; indeterminate colitis: 2) were enrolled in the study (age: 43 ± 14 years/M ± SD). Disease duration of all patients averaged 10 ± 8.5 years. In 519 UC-patients (49% male; 33% pancolitis), 66% were in remission as were 55% of CD patients (37 % male; 41 % active smokers). Associated with higher rates of disease activity (CDAI ≥ 150; CAI>4) were corticosteroids (CD, UC), topical medication (UC), relevant reported depressive symptoms (15%; 6-31%) and impairments in sexuality (21%; 9-42%). Relevant medication groups prescribed were oral aminosalicylates (UC: 70%; CD: 47%); immunosuppressive therapy - mostly azathioprine/6 MP (CD: 47%; UC: 26%), and Infliximab (CD: 8%; UC: 3%). Strongly associated with their clinical disease activity in UC as well as CD patients, 15% (6-31%) reported relevant depressive symptoms and 21% (9-42%) relevant impairments in sexuality.
The registry constitutes a large complemental database for the patient population in Germany. About one third of the IBD patients were not in clinical remission (CDAI ≥150/CAI >4) (CD: 45%; UC: 27%), although high rates of immunosuppressive drugs (CD: 47%; UC 26%) were administered. This study shows a large burden of active disease associated with an unexpectedly high (co)morbidity and high psychosocial impairments, indicating a reduced health state in IBD patients.
本横断面研究旨在建立一个炎症性肠病（IBD）在线登记系统，以初步了解德国 IBD 门诊患者的治疗情况。
2006 年 3 月至 2007 年 7 月，德国 24 家胃肠病专科诊所和 2 家医院的 IBD 门诊患者纳入了一项基于互联网的登记研究，以评估门诊患者的临床状况、心理障碍、提供的医疗保健以及医疗和药物治疗费用。
该研究共纳入 1032 名 IBD 患者（溃疡性结肠炎/UC：519 例；克罗恩病/CD：511 例；不确定结肠炎：2 例）（年龄：43±14 岁/M±SD）。所有患者的疾病病程平均为 10±8.5 年。在 519 例 UC 患者中（49%为男性；33%为全结肠炎），66%处于缓解期，55%的 CD 患者（37%为男性；41%为吸烟者）处于缓解期。疾病活动度较高（CDAI≥150；CAI>4）的患者与皮质类固醇（CD、UC）、局部药物治疗（UC）、报告的抑郁症状（15%；6-31%）和性功能障碍（21%；9-42%）相关。处方的相关药物组为口服氨基水杨酸（UC：70%；CD：47%）；免疫抑制治疗-主要为硫唑嘌呤/6-MP（CD：47%；UC：26%）和英夫利昔单抗（CD：8%；UC：3%）。UC 和 CD 患者的临床疾病活动度与抑郁症状（15%（6-31%））和性功能障碍（21%（9-42%））显著相关。
该登记系统是德国患者人群的大型补充数据库。大约三分之一的 IBD 患者（CDAI≥150/CAI>4）未处于临床缓解状态（CD：45%；UC：27%），尽管给予了高比例的免疫抑制剂（CD：47%；UC 26%）。本研究显示，活动期疾病负担较大，同时伴有意外高（共）发病率和高心理社会障碍，表明 IBD 患者的健康状况下降。
