Bollen Lize, Vande Casteele Niels, Ballet Vera, van Assche Gert, Ferrante Marc, Vermeire Séverine, Gils Ann
aLaboratory for Therapeutic and Diagnostic Antibodies, Department of Pharmaceutical and Pharmacological Sciences, Katholieke Universiteit Leuven bTranslational Research in Gastrointestinal Disorders, Department of Gastroenterology, UZ Leuven, Leuven, Belgium.
Eur J Gastroenterol Hepatol. 2016 Jan;28(1):1-7. doi: 10.1097/MEG.0000000000000495.
Patients with inflammatory bowel disease (IBD) have a higher risk of developing thromboembolic events (TE) compared with the healthy population.
This study aimed to describe a cohort of IBD patients with a history of TE focusing on recurrence of TE, disease activity and IBD medication at the time of TE and surgery before TE.
In a retrospective monocentric cohort study, we included IBD patients in whom an arterial and/or venous TE occurred.
Eighty-four IBD patients with a history of TE (63% Crohn's disease, 44% men) and a mean age of 45±15 years were included; 25/84 patients (30%) were identified to have recurrent TE. Seventy out of 84 (83%) developed a venous TE, with a deep vein thrombosis as the major manifestation (28/70, 40%), followed by a pulmonary embolism (16/70, 23%). At the time of TE, 60/84 (71%) patients were diagnosed with active disease. In all, 23% patients were on 5-aminosalicylic acids, 36% on steroids, 18% on azathioprine, 5% on methotrexate, 12% on biologicals and 23% were not receiving specific IBD treatment. Moreover, within a 6-month period preceding the TE, 28/84 (33%) patients underwent surgery, of whom 17% received thromboprophylaxis at hospital discharge.
We confirm the association between disease activity and the occurrence of TE. A substantial number of patients had additional risk factors such as recurrence of TE. In all, 36% received steroids at the time of TE and 33% underwent recent surgery, of whom only a minority received thromboprophylaxis at hospital discharge. Further efforts are required to increase thromboprophylaxis in at-risk patients.
与健康人群相比，炎症性肠病（IBD）患者发生血栓栓塞事件（TE）的风险更高。
本研究旨在描述一组有TE病史的IBD患者，重点关注TE的复发、疾病活动度以及TE发生时和TE前手术时的IBD用药情况。
在一项回顾性单中心队列研究中，我们纳入了发生动脉和/或静脉TE的IBD患者。
纳入了84例有TE病史的IBD患者（63%为克罗恩病，44%为男性），平均年龄45±15岁；25/84例患者（30%）被确定有TE复发。84例中有70例（83%）发生了静脉TE，主要表现为深静脉血栓形成（28/70，40%），其次是肺栓塞（16/70，23%）。在TE发生时，60/84例（71%）患者被诊断为疾病活动期。总体而言，23%的患者使用5-氨基水杨酸类药物，36%使用类固醇，18%使用硫唑嘌呤，5%使用甲氨蝶呤，12%使用生物制剂，23%未接受特异性IBD治疗。此外，在TE发生前6个月内，28/84例（33%）患者接受了手术，其中17%在出院时接受了血栓预防。
我们证实了疾病活动度与TE发生之间的关联。相当一部分患者有其他风险因素，如TE复发。总体而言，36%的患者在TE发生时使用了类固醇，33%近期接受了手术，其中只有少数患者在出院时接受了血栓预防。需要进一步努力提高对高危患者的血栓预防措施。
