Zezos Petros, Kouklakis Georgios, Saibil Fred
Petros Zezos, Georgios Kouklakis, Gastrointestinal Endoscopy Unit, University General Hospital of Alexandroupolis, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
World J Gastroenterol. 2014 Oct 14;20(38):13863-78. doi: 10.3748/wjg.v20.i38.13863.
Patients with inflammatory bowel disease (IBD) have an increased risk of vascular complications. Thromboembolic complications, both venous and arterial, are serious extraintestinal manifestations complicating the course of IBD and can lead to significant morbidity and mortality. Patients with IBD are more prone to thromboembolic complications and IBD per se is a risk factor for thromboembolic disease. Data suggest that thrombosis is a specific feature of IBD that can be involved in both the occurrence of thromboembolic events and the pathogenesis of the disease. The exact etiology for this special association between IBD and thromboembolism is as yet unknown, but it is thought that multiple acquired and inherited factors are interacting and producing the increased tendency for thrombosis in the local intestinal microvasculature, as well as in the systemic circulation. Clinicians' awareness of the risks, and their ability to promptly diagnose and manage tromboembolic complications are of vital importance. In this review we discuss how thromboembolic disease is related to IBD, specifically focusing on: (1) the epidemiology and clinical features of thromboembolic complications in IBD; (2) the pathophysiology of thrombosis in IBD; and (3) strategies for the prevention and management of thromboembolic complications in IBD patients.
炎症性肠病(IBD)患者发生血管并发症的风险增加。静脉和动脉血栓栓塞并发症是使IBD病情复杂化的严重肠外表现,可导致显著的发病率和死亡率。IBD患者更容易发生血栓栓塞并发症,IBD本身就是血栓栓塞性疾病的一个危险因素。数据表明,血栓形成是IBD的一个特殊特征,它可能与血栓栓塞事件的发生以及疾病的发病机制都有关。IBD与血栓栓塞之间这种特殊关联的确切病因尚不清楚,但人们认为多种后天获得性和遗传性因素相互作用,导致局部肠道微血管系统以及全身循环中血栓形成的倾向增加。临床医生对这些风险的认识以及他们及时诊断和处理血栓栓塞并发症的能力至关重要。在这篇综述中,我们讨论血栓栓塞性疾病与IBD的关系,特别关注:(1)IBD中血栓栓塞并发症的流行病学和临床特征;(2)IBD中血栓形成的病理生理学;(3)IBD患者血栓栓塞并发症的预防和管理策略。