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克罗恩病相关贫血:炎症性肠病的隐匿面孔。

Anemia in Crohn's Disease-The Unseen Face of Inflammatory Bowel Disease.

机构信息

Medicale I Department "Grigore T. Popa", University of Medicine and Pharmacy, 700111 Iasi, Romania.

Institute of Gastroenterology and Hepatology, St. Spiridon Emergency Hospital, 700111 Iasi, Romania.

出版信息

Medicina (Kaunas). 2021 Sep 30;57(10):1046. doi: 10.3390/medicina57101046.

Abstract

: Anemia is the most frequent complication of inflammatory bowel diseases. Clinically, anemia can affect important quality-of-life (QoL) components, such as exercise capacity, cognitive function, and the ability to carry out social activities. The disease activity has a significant impact on QoL, mainly due to clinical manifestations, which are more severe during the periods of disease activity. Our aim was to estimate the impact of anemia on QoL in patients with Crohn's disease. . We made a prospective study on 134 patients with Crohn's disease (CD) in a Romanian tertiary center. The CD diagnosis was established by colonoscopy and histopathological examination. In particular cases, additional examinations were required (small bowel capsule endoscopy, computed tomography enterography, and magnetic resonance enterography). Anemia was defined according to the World Health Organization's definition, the activity of the disease was assessed by Crohn's disease activity index (CDAI) score, and the QoL was evaluated by Inflammatory Bowel Disease Questionnaire 32 (IBDQ 32). : 44.8% patient had anemia, statistically related to the activity of the disease and corticoids use. We found a strong association between QoL and disease activity on all four sub-scores: patients with more severe activity had a significantly lower IBDQ (260.38 ± 116.96 vs. 163.85 ± 87.20, = 0.001) and the presence of anemia (127.03 vs. 148.38, = 0.001). In multiple regression analyses, both disease activity and anemia had an impact on the QoL. : Anemia has high prevalence in the CD in northeastern region of Romania. Anemia was more common in female patients, in patients undergoing corticosteroid treatment, and in those with active disease. Both anemia and disease activity had a strong negative and independent impact on QoL.

摘要

贫血是炎症性肠病最常见的并发症。临床上,贫血会影响重要的生活质量(QoL)方面,如运动能力、认知功能和进行社交活动的能力。疾病活动度对 QoL 有重大影响,主要是由于临床表现,在疾病活动期更为严重。我们的目的是评估贫血对克罗恩病患者 QoL 的影响。我们在罗马尼亚的一个三级中心对 134 例克罗恩病(CD)患者进行了前瞻性研究。CD 的诊断通过结肠镜检查和组织病理学检查确定。在特殊情况下,需要进行额外的检查(小肠胶囊内镜检查、计算机断层扫描肠造影术和磁共振肠造影术)。贫血根据世界卫生组织的定义定义,疾病活动度通过克罗恩病活动指数(CDAI)评分评估,QoL 通过炎症性肠病问卷 32(IBDQ 32)评估。44.8%的患者有贫血,与疾病活动度和皮质激素使用呈统计学相关。我们发现 QoL 与所有四个子评分的疾病活动度之间存在强烈关联:活动度更严重的患者 IBDQ 显著更低(260.38±116.96 与 163.85±87.20,=0.001),且贫血的发生率更高(127.03 与 148.38,=0.001)。在多元回归分析中,疾病活动度和贫血均对 QoL 有影响。罗马尼亚东北部地区的 CD 患者中贫血的患病率较高。贫血更常见于女性患者、接受皮质类固醇治疗的患者和活动期疾病患者。贫血和疾病活动度对 QoL 均有强烈的负面影响且独立。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2881/8539193/28b7b8bca6e5/medicina-57-01046-g001.jpg

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