Fagagnini Stefania, Heinrich Henriette, Rossel Jean-Benoît, Biedermann Luc, Frei Pascal, Zeitz Jonas, Spalinger Marianne, Battegay Edouard, Zimmerli Lukas, Vavricka Stephan R, Rogler Gerhard, Scharl Michael, Misselwitz Benjamin
Division of Gastroenterology and Hepatology, University Hospital Zurich (USZ) and Zurich University, Zurich, Switzerland.
Division of Internal Medicine, University Hospital Zurich, and Zurich University, Zurich, Switzerland.
PLoS One. 2017 Oct 12;12(10):e0185193. doi: 10.1371/journal.pone.0185193. eCollection 2017.
Gallstones and kidney stones are known complications of inflammatory bowel diseases (IBD). Risk factors have been insufficiently studied and explanatory studies date back up to 30 years. It remains unclear, whether improved treatment options also influenced risk factors for these complications.
Identifying risk factors for gallstones and kidney stones in IBD patients.
Using data from the Swiss Inflammatory Bowel Disease Cohort Study we assessed associations of diseases characteristics with gallstones and kidney stones in univariate and multivariate logistic regression analyses.
Out of 2323 IBD patients, 104 (7.8%) Crohn's disease (CD) and 38 (3.8%) ulcerative colitis (UC) patients were diagnosed with gallstones. Significant risk factors for gallstones were diagnosis of CD, age at diagnosis, disease activity and duration, NSAID intake, extra-intestinal manifestations and intestinal surgery. Kidney stones were described in 61 (4.6%) CD and 30 (3.0%) UC patients. Male gender, disease activity, intestinal surgery, NSAID usage and reduced physical activity were significant risk factors. Hospitalization was associated with gallstones and kidney stones. The presence of gallstones increased the risk for kidney stones (OR 4.87, p<0.001).
The diagnosis of CD, intestinal surgery, prolonged NSAID use, disease activity and duration and bowel stenosis were significantly associated with cholecystonephrolithiasis in IBD.
胆结石和肾结石是炎症性肠病（IBD）已知的并发症。危险因素尚未得到充分研究，相关解释性研究可追溯到30年前。目前尚不清楚，治疗方案的改善是否也影响了这些并发症的危险因素。
确定IBD患者胆结石和肾结石的危险因素。
利用瑞士炎症性肠病队列研究的数据，我们在单变量和多变量逻辑回归分析中评估了疾病特征与胆结石和肾结石的关联。
在2323例IBD患者中，104例（7.8%）克罗恩病（CD）患者和38例（3.8%）溃疡性结肠炎（UC）患者被诊断为胆结石。胆结石的显著危险因素包括CD诊断、诊断时年龄、疾病活动度和病程、非甾体抗炎药摄入、肠外表现和肠道手术。61例（4.6%）CD患者和30例（3.0%）UC患者被诊断有肾结石。男性、疾病活动度、肠道手术、非甾体抗炎药使用和体力活动减少是显著危险因素。住院与胆结石和肾结石有关。胆结石的存在增加了肾结石的风险（比值比4.87，p<0.001）。
CD诊断、肠道手术、长期使用非甾体抗炎药、疾病活动度和病程以及肠狭窄与IBD患者的胆石肾结石显著相关。
