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肺部疾病与炎症性肠病的关联患病率。

Prevalence of Pulmonary Diseases in Association with Inflammatory Bowel Disease.

机构信息

Department of Medicine, SUNY Upstate Medical Center, Syracuse, NY, USA.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.

出版信息

Dig Dis Sci. 2022 Nov;67(11):5187-5194. doi: 10.1007/s10620-022-07385-z. Epub 2022 Feb 10.

Abstract

BACKGROUND

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.

METHODS

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).

RESULTS

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.

CONCLUSION

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.

摘要

背景

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。

方法

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。

结果

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%。

结论

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。

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