Department of Medicine, SUNY Upstate Medical Center, Syracuse, NY, USA.
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Dig Dis Sci. 2022 Nov;67(11):5187-5194. doi: 10.1007/s10620-022-07385-z. Epub 2022 Feb 10.
Prior reports from small studies suggested an increased prevalence of respiratory diseases in patients with inflammatory bowel disease (IBD). Large population-based contemporary studies evaluating this association are lacking.
In this retrospective observational cohort study utilizing the US Nationwide Readmissions Database year 2014, IBD patients ≥ 15 years of age were identified. Outcomes analyzed were the differences in the rates of diagnosed respiratory diseases between IBD and age- and sex-matched non-IBD control groups, and between patients with ulcerative colitis (UC) and Crohn disease (CD).
The IBD study cohort and the matched non-IBD control group had 87,506 patients each (mean age, 52 years; 57% females). In patients with IBD, obstructive respiratory diseases were the most prevalent (asthma, 8.6%; and chronic obstructive pulmonary disease, 8.7%) followed by pleural diseases (1.9%). Compared with the non-IBD cohort, patients with IBD had a 46% higher rate of bronchiectasis, 52% higher rate of pulmonary vasculitis and interstitial pneumonia, 35% higher risk for lung nodules, 16% higher rate of pulmonary fibrosis, and a 5.5% higher rate of asthma. Among patients with IBD, patients with CD, compared with UC, had a 34% lower age/sex-adjusted risk for bronchiectasis, 56% lower risk for pulmonary vasculitis, 14% lower risk for pleural diseases, and approximately 30% higher risk for chronic obstructive pulmonary diseases.
In this large population-based cohort study, patients with IBD had higher rates of certain respiratory diseases compared with the general population without IBD, and significant differences were present between CD and UC.
先前的小样本研究报告表明，炎症性肠病（IBD）患者的呼吸系统疾病患病率增加。缺乏评估这种关联的大型基于人群的当代研究。
本回顾性观察性队列研究利用美国全国再入院数据库 2014 年的数据，确定了≥15 岁的 IBD 患者。分析的结果是 IBD 患者与年龄和性别匹配的非 IBD 对照组之间以及溃疡性结肠炎（UC）和克罗恩病（CD）患者之间诊断的呼吸系统疾病发生率的差异。
IBD 研究队列和匹配的非 IBD 对照组各有 87506 例患者（平均年龄 52 岁；女性占 57%）。在 IBD 患者中，最常见的是阻塞性呼吸系统疾病（哮喘，8.6%；慢性阻塞性肺疾病，8.7%），其次是胸膜疾病（1.9%）。与非 IBD 队列相比，IBD 患者支气管扩张症的发病率高 46%，肺血管炎和间质性肺炎的发病率高 52%，肺结节的风险高 35%，肺纤维化的发病率高 16%，哮喘的发病率高 5.5%。在 IBD 患者中，与 UC 相比，CD 患者支气管扩张症的年龄/性别调整风险低 34%，肺血管炎的风险低 56%，胸膜疾病的风险低 14%，慢性阻塞性肺疾病的风险高约 30%。
在这项大型基于人群的队列研究中，与没有 IBD 的一般人群相比，IBD 患者某些呼吸系统疾病的发病率较高，并且 CD 和 UC 之间存在显著差异。
