欧洲国家炎症性肠病贫血患病率：系统评价与个体患者数据荟萃分析
Prevalence of anemia in inflammatory bowel diseases in european countries: a systematic review and individual patient data meta-analysis.
作者信息
Filmann Natalie, Rey Julia, Schneeweiss Sven, Ardizzone Sandro, Bager Palle, Bergamaschi Gaetano, Koutroubakis Ioannis, Lindgren Stefan, Morena Felipe de la, Moum Bjørn, Vavricka Stephan R, Schröder Oliver, Herrmann Eva, Blumenstein Irina
机构信息
*Institute of Biostatistics and Mathematical Modeling, Faculty of Medicine, and †Department of Internal Medicine 1, Goethe-University Hospital, Frankfurt, Germany; ‡IBD Unit, Chair of Gastroenterology, L. Sacco University Hospital, Milan, Italy; §Department of Medicine V (Hepatology and Gastroenterology), Aarhus University Hospital, Aarhus, Denmark; ‖Dip. Area Medica: Medicina Generale 1, Policlinico San Matteo, Pavia, Italy; ¶Department of Gastroenterology, University Hospital Heraklion, Crete, Greece; **Department of Gastroenterology, University Hospital Skane, Malmö, Sweden; ††Sección de Aparato Digestivo, Hospital Infanta Cristina, Parla, Madrid, Spain; ‡‡Department of Gastroenterology, Oslo University Hospital, Oslo, Norway; and §§Division of Gastroenterology, Triemli Hospital, Zurich, Switzerland.
出版信息
Inflamm Bowel Dis. 2014 May;20(5):936-45. doi: 10.1097/01.MIB.0000442728.74340.fd.
BACKGROUND
The main objective is to determine the overall prevalence of anemia in inflammatory bowel diseases (IBD) in Europe.
METHODS
A systematic literature search in PubMed and Embase was performed for studies published between January 2007 and May 2012. Eligible studies were included if they were original full-paper publications originated from Europe and if the authors agreed to provide their data. An overall prevalence of anemia in IBD, disease specific, and age-gender stratified basis prevalences were estimated. The influence of disease entity (Crohn's disease/ulcerative colitis), gender, age, disease activity (remission/active disease), and IBD-specific treatment strategies on the prevalence of anemia was analyzed by a mixed logistic regression model. Thereby, the factor country of origin was included as a random effect.
RESULTS
Data were available for 2192 patients, mainly treated in tertiary referral centers. The overall prevalence of anemia in IBD patients was 24% (95% confidence interval, 18-31). Age-gender stratified prevalences were estimated for the age strata 18 to 29, 30 to 39, 40 to 49, 50 to 64, 65 to 74, >74 years and ranged from 18% to 35%. Patients receiving IBD-specific medication (P = 0.0002, odds ratio 1.54), and patients with active disease status (P < 0.0001, odds ratio 2.72) were significantly more likely to have anemia compared with patients not receiving IBD-specific medication or being in remission. Patients with ulcerative colitis tended to have anemia less likely than patients with Crohn's disease (P = 0.01, odds ratio 0.77).
CONCLUSIONS
The overall prevalence of anemia in patients with Crohn's disease was 27% (95% confidence interval, 19-35) and 21% (95% confidence interval, 15-27) in patients with ulcerative colitis. Thereby, 57% of the anemic patients were iron deficient.
背景
主要目的是确定欧洲炎症性肠病（IBD）患者贫血的总体患病率。
方法
在PubMed和Embase中对2007年1月至2012年5月发表的研究进行系统文献检索。符合条件的研究需为源自欧洲的原创全文出版物，且作者同意提供其数据。估计了IBD患者贫血的总体患病率、疾病特异性患病率以及年龄 - 性别分层患病率。通过混合逻辑回归模型分析疾病实体（克罗恩病/溃疡性结肠炎）、性别、年龄、疾病活动度（缓解期/活动期疾病）和IBD特异性治疗策略对贫血患病率的影响。其中，将原产国因素作为随机效应纳入分析。
结果
共有2192例患者的数据可供分析，这些患者主要在三级转诊中心接受治疗。IBD患者贫血的总体患病率为24%（95%置信区间，18 - 31）。对18至29岁、30至39岁、40至49岁、50至64岁、65至74岁、74岁以上年龄组的年龄 - 性别分层患病率进行了估计，范围在18%至35%之间。与未接受IBD特异性药物治疗或处于缓解期的患者相比，接受IBD特异性药物治疗的患者（P = 0.0002，比值比1.54）以及处于疾病活动期的患者（P < 0.0001，比值比2.72）患贫血的可能性显著更高。溃疡性结肠炎患者患贫血的可能性往往低于克罗恩病患者（P = 0.01，比值比0.77）。
结论
克罗恩病患者贫血的总体患病率为27%（95%置信区间，19 - 35），溃疡性结肠炎患者为21%（95%置信区间，15 - 27）。其中，57%的贫血患者缺铁。
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