Department of Internal Medicine, The Cleveland Clinic Foundation, Cleveland, OH, USA.
Department of Gastroenterology and Hepatology, The Cleveland Clinic Foundation, Cleveland OH, USA.
Gastroenterol Rep (Oxf). 2016 Aug;4(3):210-5. doi: 10.1093/gastro/gov012. Epub 2015 Apr 28.
Our aim was to assess the risk factors for non-surgery-related portal and mesenteric vein thrombosis (PMVT) and its impact on the outcomes of inflammatory bowel diseases (IBD).
All patients with a concurrent diagnosis of IBD and PMVT between January 2004 and October 2013 were identified from the electronic medical record (study group; n = 20). Patients were matched for age, sex, and IBD phenotype with control IBD patients who had no PMVT, with a ratio of 1:3 (control group; n = 60). Risk factors for PMVT and IBD-related outcomes at one year after diagnosis of PMVT were compared between the two groups.
Of the 20 patients in the Study group, 6 (30%) had UC, 14 (70%) had CD and 11 (55%) were male. On multivariable analysis, inpatient status (odds ratio [OR] 6.88; 95% confidence interval [CI] 1.88-25.12) and baseline corticosteroid use (OR 4.39; 95% CI 1.27-15.19) were found to be independent risk factors for the development of PMVT. At one-year follow-up, PMVT patients were more likely to have an adverse outcome of IBD, including subsequent emergency room visit (26.3% vs. 1.7%; P = 0.003), hospitalization for medical management (60.0% vs. 20.0%; P = 0.001) or IBD-related surgery (65.0% vs. 26.7%; P = 0.003) than the non-PMVT controls. In multivariable analysis, PMVT (OR 5.19; 95% CI 1.07-25.28) and inpatient status (OR 8.92; 95% CI 1.33-59.84) were found to be independent risk factors for poor outcome, whereas baseline immunomodulator use (OR 0.07; 95% CI 0.01-0.51) was found to be a protective factor.
IBD patients who were inpatients or receiving corticosteroid therapy had an increased risk of the development of PMVT. The presence of PMVT was associated with poor clinical outcomes in IBD.
评估非手术相关门静脉和肠系膜静脉血栓形成（PMVT）的风险因素及其对炎症性肠病（IBD）结局的影响。
从电子病历中确定了 2004 年 1 月至 2013 年 10 月期间同时诊断为 IBD 和 PMVT 的所有患者（研究组；n=20）。为每个患者匹配年龄、性别和 IBD 表型相同的 3 个 IBD 患者作为对照（对照组；n=60）。比较两组患者在 PMVT 诊断后 1 年时的 PMVT 相关风险因素和 IBD 相关结局。
研究组 20 例患者中，6 例（30%）为 UC，14 例（70%）为 CD，11 例（55%）为男性。多变量分析显示，住院状态（比值比[OR]6.88；95%置信区间[CI]1.88-25.12）和基线皮质类固醇使用（OR 4.39；95%CI 1.27-15.19）是 PMVT 发展的独立危险因素。在 1 年随访时，PMVT 患者更有可能出现 IBD 的不良结局，包括随后急诊就诊（26.3%比 1.7%；P=0.003）、因医疗管理住院（60.0%比 20.0%；P=0.001）或 IBD 相关手术（65.0%比 26.7%；P=0.003）的比例高于非 PMVT 对照组。多变量分析显示，PMVT（OR 5.19；95%CI 1.07-25.28）和住院状态（OR 8.92；95%CI 1.33-59.84）是不良结局的独立危险因素，而基线免疫调节剂使用（OR 0.07；95%CI 0.01-0.51）是保护因素。
住院或接受皮质类固醇治疗的 IBD 患者发生 PMVT 的风险增加。PMVT 的存在与 IBD 的不良临床结局相关。
