Gastromed - Department of Gastroenterology and Endoscopy, Rio de Janeiro, Brazil.
Department of Life Science, Bahia State University (UNEB), Salvador, Brazil.
Sci Rep. 2024 Feb 21;14(1):4314. doi: 10.1038/s41598-024-54332-1.
The Brazilian Organization for Crohn's Disease and Colitis (GEDIIB) established a national registry of inflammatory bowel disease (IBD). The aim of the study was to identify clinical factors associated with disease severity in IBD patients in Brazil. A population-based risk model aimed at stratifying the severity of IBD based on previous hospitalization, use of biologics, and need for surgery for ulcerative colitis (UC) and Crohn's Disease (CD) and on previous complications for CD. A total of 1179 patients (34.4 ± 14.7y; females 59%) were included: 46.6% with UC, 44.2% with CD, and 0.9% with unclassified IBD (IBD-U). The time from the beginning of the symptoms to diagnosis was 3.85y. In CD, 41.2% of patients presented with ileocolic disease, 32% inflammatory behavior, and 15.5% perianal disease. In UC, 46.3% presented with extensive colitis. Regarding treatment, 68.1%, 67%, and 47.6% received biological therapy, salicylates and immunosuppressors, respectively. Severe disease was associated with the presence of extensive colitis, EIM, male, comorbidities, and familial history of colorectal cancer in patients with UC. The presence of Montreal B2 and B3 behaviors, colonic location, and EIM were associated with CD severity. In conclusion, disease severity was associated with younger age, greater disease extent, and the presence of rheumatic EIM.
巴西克罗恩病和结肠炎组织(GEDIIB)建立了一个炎症性肠病(IBD)国家登记处。该研究的目的是确定与巴西 IBD 患者疾病严重程度相关的临床因素。该研究建立了一个基于人群的风险模型,旨在根据溃疡性结肠炎(UC)和克罗恩病(CD)的既往住院、生物制剂使用和手术需求以及 CD 的既往并发症,对 IBD 的严重程度进行分层。共纳入 1179 例患者(34.4±14.7 岁;女性 59%):46.6%为 UC,44.2%为 CD,0.9%为未分类 IBD(IBD-U)。从症状开始到诊断的时间为 3.85 年。在 CD 中,41.2%的患者表现为回结肠疾病,32%表现为炎症行为,15.5%表现为肛周疾病。在 UC 中,46.3%的患者表现为广泛性结肠炎。关于治疗,分别有 68.1%、67%和 47.6%的患者接受了生物治疗、柳氮磺胺吡啶和免疫抑制剂治疗。UC 患者中,广泛结肠炎、肠外表现、男性、合并症和结直肠癌家族史与严重疾病相关。存在蒙特利尔 B2 和 B3 行为、结肠病变和肠外表现与 CD 严重程度相关。总之,疾病严重程度与年龄较小、疾病范围较大以及存在风湿性肠外表现有关。