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中国炎症性肠病患者心血管事件的风险:一项回顾性多中心队列研究。

Risks of Cardiovascular Events in Patients With Inflammatory Bowel Disease in China: A Retrospective Multicenter Cohort Study.

机构信息

Center for Inflammatory Bowel Disease Research, The Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China.

Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan Province 650032, China.

出版信息

Inflamm Bowel Dis. 2022 Jun 2;28(Supple 2):S52-S58. doi: 10.1093/ibd/izab326.

Abstract

BACKGROUND

Inflammatory bowel disease (IBD) is a complex chronic disorder characterized by systemic inflammation, which may cause abnormal state of coagulation, resulting in cardiac events. This study aimed to investigate the incidences and risks of cardiac events in patients with IBD in China.

METHODS

A retrospective cohort study was performed comprising 1435 patients with IBD from 12 IBD centers in China. Cases were matched with 1588 eligible participants without IBD from 12 medical centers according to age, sex, and laboratory parameters.

RESULTS

Patients with IBD in China exhibited significantly higher incidences of ischemic heart disease (IHD; coronary heart disease included) but lower frequencies of right bundle branch block and premature contraction than those of matched controls. The risk of IHD increased in patients with IBD, peaking at the age of 18-35 years. Female patients with IBD were more likely to experience IHD than male patients. The C-reactive protein (CRP) levels and neutrophil count in the peripheral blood were positively related with the risk of IHD among patients with Crohn's disease, whereas plasma fibrinogen levels were negatively related with the risk of IHD both in patients with Crohn's disease and ulcerative colitis.

CONCLUSIONS

The risk of IHD is increased in patients with IBD, especially in young female patients with IBD when compared with matched non-IBD subjects. The CRP and plasma fibrinogen levels and neutrophil count in the peripheral blood may be potential predictors associated with the occurrence of IHD in patients with IBD. The study's findings have significant implications for the management and prevention of cardiac events in patients with IBD.

摘要

背景

炎症性肠病(IBD)是一种以全身炎症为特征的复杂慢性疾病,可能导致凝血异常,从而引发心脏事件。本研究旨在探讨中国 IBD 患者发生心脏事件的发生率和风险。

方法

本研究采用回顾性队列研究,纳入中国 12 个 IBD 中心的 1435 例 IBD 患者。根据年龄、性别和实验室参数,将病例与来自 12 个医疗中心的 1588 例符合条件的非 IBD 对照者相匹配。

结果

中国 IBD 患者的缺血性心脏病(IHD;包括冠心病)发生率显著高于对照组,但右束支传导阻滞和早搏的发生率低于对照组。IBD 患者的 IHD 风险增加,在 18-35 岁年龄组达到峰值。与男性患者相比,女性 IBD 患者更易发生 IHD。克罗恩病患者外周血 C 反应蛋白(CRP)水平和中性粒细胞计数与 IHD 风险呈正相关,而血浆纤维蛋白原水平与克罗恩病和溃疡性结肠炎患者的 IHD 风险呈负相关。

结论

与匹配的非 IBD 对照者相比,IBD 患者发生 IHD 的风险增加,尤其是年轻女性 IBD 患者。CRP 和血浆纤维蛋白原水平以及外周血中性粒细胞计数可能是与 IBD 患者发生 IHD 相关的潜在预测因素。该研究结果对 IBD 患者心脏事件的管理和预防具有重要意义。

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