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基于共识的诊断分类的肠型贝赫切特病患者的临床病程。

Clinical Course of Patients with Intestinal Behçet's Disease According to Consensus-Based Diagnostic Categories.

机构信息

Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Catholic Photomedicine Research Institute, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Gut Liver. 2022 Sep 15;16(5):746-753. doi: 10.5009/gnl210308. Epub 2021 Dec 17.

Abstract

BACKGROUND/AIMS: There have been few studies regarding the prognosis of intestinal Behçet's disease (iBD) patients according to consensus-based diagnostic categories, which reflects the typicality of intestinal ulcers, the presence of oral ulcers, and the accompanying systemic manifestations.

METHODS

The medical records of patients who had ileocolonic ulcers with a clinical impression of iBD were reviewed. The patients were categorized according to the diagnostic algorithm at the time of diagnosis. Adverse events were defined as major surgery or admission related to iBD deterioration.

RESULTS

A total of 163 patients were included in the study. The male-to-female ratio was 1:1.2, and the mean age at the time of diagnosis was 48.9±15.9 years. The numbers of patients who met the definite, probable, suspected, and nondiagnostic iBD criteria were 19 (11.7%), 61 (37.4%), 38 (23.3%), and 45 (27.6%), respectively. The event-free survival of patients with definite, probable, and suspected iBD was significantly shorter than that of patients with nondiagnostic iBD (p=0.026), while there was no significant difference among the definite iBD, probable iBD, and suspected iBD groups (p=0.596). After excluding patients with nondiagnostic iBD, multivariate analysis showed that anemia, fever, colonic involvement other than the ileocecum, and accompanying hematologic disorders at the time of diagnosis were significantly associated with the development of adverse events.

CONCLUSIONS

The clinical course of patients with definite, probable, and suspected iBD is distinguished from that of patients with nondiagnostic iBD, but patients with definite, probable, and suspected iBD share similar clinical courses.

摘要

背景/目的:根据基于共识的诊断标准,针对肠型贝赫切特病(iBD)患者的预后进行的研究较少,这些标准反映了肠溃疡的典型性、口腔溃疡的存在以及伴随的全身表现。

方法

回顾了有临床印象的 iBD 患者出现回结肠溃疡的病历。根据诊断时的诊断算法对患者进行分类。不良事件定义为与 iBD 恶化相关的重大手术或住院。

结果

共纳入 163 例患者。男女比例为 1:1.2,诊断时的平均年龄为 48.9±15.9 岁。符合明确、可能、疑似和非诊断 iBD 标准的患者分别为 19 例(11.7%)、61 例(37.4%)、38 例(23.3%)和 45 例(27.6%)。明确、可能和疑似 iBD 患者的无事件生存时间明显短于非诊断 iBD 患者(p=0.026),但明确 iBD、可能 iBD 和疑似 iBD 三组之间无显著差异(p=0.596)。排除非诊断 iBD 患者后,多变量分析显示,诊断时存在贫血、发热、回盲部以外的结肠受累和伴随的血液系统疾病与不良事件的发生显著相关。

结论

明确、可能和疑似 iBD 患者的临床病程与非诊断 iBD 患者不同,但明确、可能和疑似 iBD 患者的临床病程相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5624/9474495/9340fbf54160/gnl-16-5-746-f1.jpg

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