Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark.
1st Department of Medicine, Semmelweis University, Budapest, Hungary.
J Crohns Colitis. 2017 Oct 1;11(10):1213-1222. doi: 10.1093/ecco-jcc/jjx077.
Anaemia is an important complication of inflammatory bowel disease [IBD]. The aim of this study was to determine the prevalence of anaemia and the practice of anaemia screening during the first year following diagnosis, in a European prospective population-based inception cohort.
Newly diagnosed IBD patients were included and followed prospectively for 1 year in 29 European and one Australian centre. Clinical data including demographics, medical therapy, surgery and blood samples were collected. Anaemia was defined according to the World Health Organization criteria.
A total of 1871 patients (Crohn's disease [CD]: 686, 88%; ulcerative colitis [UC]: 1,021, 87%; IBD unclassified [IBDU] 164. 81%) were included in the study. The prevalence of anaemia was higher in CD than in UC patients and, overall, 49% of CD and 39% of UC patients experienced at least one instance of anaemia during the first 12 months after diagnosis. UC patients with more extensive disease and those from Eastern European countries, and CD patients with penetrating disease or colonic disease location, had higher risks of anaemia. CD and UC patients in need of none or only mild anti-inflammatory treatment had a lower risk of anaemia. In a significant proportion of patients, anaemia was not assessed until several months after diagnosis, and in almost half of all cases of anaemia a thorough work-up was not performed.
Overall, 42% of patients had at least one instance of anaemia during the first year following diagnosis. Most patients were assessed for anaemia regularly; however, a full anaemia work-up was frequently neglected in this community setting.
贫血是炎症性肠病(IBD)的重要并发症。本研究旨在确定在欧洲前瞻性基于人群的发病队列中,诊断后第一年贫血的患病率以及贫血筛查的实施情况。
纳入新诊断的 IBD 患者,并在 29 个欧洲中心和 1 个澳大利亚中心进行前瞻性随访 1 年。收集临床数据,包括人口统计学、医学治疗、手术和血液样本。贫血根据世界卫生组织标准定义。
本研究共纳入 1871 例患者(克罗恩病[CD]:686 例,88%;溃疡性结肠炎[UC]:1021 例,87%;IBD 未分类[IBDU]:164 例,81%)。CD 患者的贫血患病率高于 UC 患者,总体而言,49%的 CD 患者和 39%的 UC 患者在诊断后 12 个月内至少发生一次贫血。疾病范围更广的 UC 患者和来自东欧国家的患者,以及穿透性疾病或结肠疾病部位的 CD 患者,贫血风险更高。无需或仅需轻度抗炎治疗的 CD 和 UC 患者贫血风险较低。在相当一部分患者中,贫血直到诊断后数月才进行评估,几乎一半的贫血病例未进行全面评估。
总体而言,42%的患者在诊断后第一年至少发生一次贫血。大多数患者定期接受贫血评估;然而,在这种社区环境下,贫血的全面评估经常被忽视。