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炎症性肠病发病机制及间充质干细胞治疗的作用与问题 预览
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作者 黄文文 李硕 +1 位作者 侯宗柳 王文举 《中国组织工程研究》 CAS 北大核心 2020年第7期1138-1143,共6页
背景:近年来,炎症性肠病的发病率逐年增加,尚无良好治疗方案。间充质干细胞在治疗系统性红斑狼疮、心肌梗死、移植物抗宿主病等多项免疫相关疾病的研究中展现出良好的效果;同时,多项研究表明,间充质干细胞在炎症性肠病的治疗中拥有独特... 背景:近年来,炎症性肠病的发病率逐年增加,尚无良好治疗方案。间充质干细胞在治疗系统性红斑狼疮、心肌梗死、移植物抗宿主病等多项免疫相关疾病的研究中展现出良好的效果;同时,多项研究表明,间充质干细胞在炎症性肠病的治疗中拥有独特优势,因此关于间充质干细胞治疗炎症性肠病的研究逐渐成为目前的热点。目的:总结间充质干细胞治疗炎症性肠病的现有研究,并对其应用前景和安全性进行展望。方法:以“间充质干细胞,炎症性肠病,发病机制,治疗”及“mesenchymal stem cells,inflammatory bowel disease,mechanisms,treatment”分别作为中、英文关键词,在中国知网数据库、万方数据库及PubMed数据库对近20年间的相关文献进行检索,最终纳入符合要求的62篇文献进行综述。结果与结论:间充质干细胞具有自我更新、组织迁移和多能性的能力以及强大的免疫调节作用,不仅在系统性红斑狼疮、心肌梗死、移植物抗宿主病等多种免疫相关疾病中表现出良好的治疗效果,同时在炎症性肠病中也拥有良好治疗表现,但目前用于临床的研究仍为少数,间充质干细胞治疗炎症性肠病仍面临安全性等多方面的问题。 展开更多
关键词 炎症性肠病 间充质干细胞 溃疡性结肠炎 克罗恩病 免疫调节
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炎症性肠病患者患病体验的Meta整合
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作者 王丹艳 周云仙 《中华现代护理杂志》 2019年第27期3527-3533,共7页
目的整合炎症性肠病患者相关患病体验的质性研究,为制订针对性的干预措施提供参考。方法检索PubMed、Web of Science、ScienceDirect、EBSCO及中国生物医学数据库、CNKI、维普和万方数据库中相关的质性研究,检索时间均为从建库至2018年1... 目的整合炎症性肠病患者相关患病体验的质性研究,为制订针对性的干预措施提供参考。方法检索PubMed、Web of Science、ScienceDirect、EBSCO及中国生物医学数据库、CNKI、维普和万方数据库中相关的质性研究,检索时间均为从建库至2018年12月,采用2016版澳大利亚JBI循证卫生保健中心质性研究质量评价标准进行文献质量评价,采取汇集性整合的方法进行结果整合。结果共纳入19项研究,提炼94个完整的研究结果,得到2个整合结果分别是:1.疾病给患者造成躯体不适与形象受损,对日常生活、工作、学习产生各种限制,引起一系列负性情绪;2.为应对患病带来的各种变化,患者调整心态,积极采取一系列应对策略,学会与疾病长期共处,重塑新的生活方式,并从中获得积极体验。结论炎症性肠病会给患者带来各种影响与限制,不少患者会采取各种应对策略,以减轻患病带来的影响,努力与疾病共存。建议医护人员给予患者必要的指导和帮助,促进其重建正常。 展开更多
关键词 CROHN 结肠炎 溃疡性 炎症性肠病 患病体验 质性研究 Meta整合
Combined evaluation of biomarkers as predictor of maintained remission in Crohn’s disease 预览
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作者 Elisa Sollelis Régine Minet Quinard +6 位作者 Guillaume Bouguen Marion Goutte Félix Goutorbe Damien Bouvier Bruno Pereira Gilles Bommelaer Anthony Buisson 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2354-2364,共11页
BACKGROUND The individual performances and the complementarity of Crohn’s disease (CD) activity index (CDAI), C-reactive protein (CRP) and faecal calprotectin (Fcal) to monitor patients with CD remain poorly inves-ti... BACKGROUND The individual performances and the complementarity of Crohn’s disease (CD) activity index (CDAI), C-reactive protein (CRP) and faecal calprotectin (Fcal) to monitor patients with CD remain poorly inves-tigated in the era of “tight control” and “treat to target” strategies. AIM To assess CDAI, CRP and Fcal variation, alone or combined, after 12 wk (W12) of anti-tumor necrosis factor (TNF) therapy to predict corticosteroids-free remission (CFREM = CDAI < 150, CRP < 2.9 mg/L and Fcal < 250 μg/g with no therapeutic intensification and no surgery) at W52. METHODS CD adult patients needing anti-TNF therapy with CDAI > 150 and either CRP > 2.9 mg/L or Fcal > 250 μg/g were prospectively enrolled.RESULTS Among the 40 included patients, 13 patients (32.5%) achieved CFREM at W52. In univariable analysis, CDAI < 150 at W12 (P = 0.012), CRP level < 2.9 mg/L at W12 (P = 0.001) and Fcal improvement at W12 (Fcal < 300 μg/g;or, for patients with initial Fcal < 300 μg/g, at least 50% decrease of Fcal or normalization of Fcal (< 100 μg/g)(P = 0.001) were predictive of CFREM at W52. Combined endpoint (CDAI < 150 and CRP ≤ 2.9 mg/L and FCal improvement) at W12 was the best predictor of CFREM at W52 with positive predictive value = 100.0%(100.0-100.0) and negative predictive value = 87.1%(75.3-98.9). In multivariable analysis, Fcal improvement at W12 [odd ratio (OR)= 45.1 (2.96-687.9);P = 0.03] was a better predictor of CFREM at W52 than CDAI < 150 [OR = 9.3 (0.36-237.1);P = 0.145] and CRP < 2.9 mg/L (0.77-278.0;P = 0.073). CONCLUSION The combined monitoring of CDAI, CRP and Fcal after anti-TNF induction therapy is able to predict favorable outcome within one year in patients with CD. 展开更多
关键词 Biomarkers Crohn's DISEASE FAECAL CALPROTECTIN Crohn's DISEASE activity index C-reactive protein Tight control ANTI-TUMOR necrosis factor
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Endoscopic response to tumor necrosis factor inhibitors predicts long term benefits in Crohn’s disease 预览
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作者 Ignacio Alfaro Maria Carme Masamunt +10 位作者 Nuria Planell Alicia López-García Jesús Castro Marta Gallego Rebeca Barastegui Angel Giner Alejandro Vara Azucena Salas Elena Ricart Julián Panés Ingrid Ordás 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第14期1764-1774,共11页
BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated wit... BACKGROUND Identifying predictors of therapeutic response is the cornerstone of personalized medicine. AIM To identify predictors of long-term mucosal healing (MH) in patients with Crohn's disease (CD) treated with tumor necrosis factor α(TNF-α) inhibitors. METHODS Prospective single center study. Consecutive patients with clinically active CD requiring treatment with a TNF-α inhibitor were included. A baseline segmental CD Endoscopic Index of Severity (CDEIS)≥ 10 in at least one segment or the presence of ulcerations were required for inclusion. Clinical, biological and endoscopic data were obtained at baseline, weeks 14 and 46. Endoscopic response (ER) was defined as a decrease ≥ 50% from baseline CDEIS and MH as partial CDEIS ≤ 5 in all segments. RESULTS Of 62 patients were included. At baseline, median CD Activity Index and CDEIS were 201 and 6.7, respectively with a significant reduction after one year of treatment (53 and 3.0 respectively, P < 0.001). At week 14, 56% of patients achieved ER and 34% MH. At week 46, the corresponding percentages were 52% and 44%. Baseline disease characteristics or biomarkers did not predict MH. A decrease from baseline CDEIS at week 14 of at least 80% was the best predictor of MH at week 46 (59% sensitivity and 91% specificity;area under the curve = 0.778).CONCLUSION Clinical and biomarker data are not useful predictors of response to TNF-α inhibitors in CD, whereas ER to induction therapy, defined as 80% reduction in global CDEIS, is a robust predictor of long-term MH. Achievement of this endoscopic endpoint may be considered as a therapeutic target for anti-TNF-α therapy. 展开更多
关键词 Crohn’s DISEASE Endoscopy MUCOSAL HEALING Crohn’s DISEASE ENDOSCOPIC Index of SEVERITY Tumor NECROSIS factor
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白细胞吸附疗法在重症炎症性肠病中的应用进展 预览
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作者 何彩玲 高苏俊 《安徽医药》 CAS 2019年第4期827-830,共4页
炎症性肠病(IBD)是一种以反复发作的、多种免疫因子参与的慢性肠道炎症,其发病率在逐年增加。其发病机制可能与机体免疫反应、肠道炎性活动、肠道功能紊乱、精神状态、遗传等因素有关。目前主要的治疗方式以营养疗法、药物治疗、单克隆... 炎症性肠病(IBD)是一种以反复发作的、多种免疫因子参与的慢性肠道炎症,其发病率在逐年增加。其发病机制可能与机体免疫反应、肠道炎性活动、肠道功能紊乱、精神状态、遗传等因素有关。目前主要的治疗方式以营养疗法、药物治疗、单克隆抗体相关的生物治疗、免疫抑制剂疗法为主,因发病机制仍不十分明确,这些疗法都不能完全有效地控制炎症的发展。近年来研究发现,血液中的白细胞(中性白细胞和单核细胞)的激活在IBD的发生与发展中起着至关重要的作用,因此,有效地清除血液中激活的白细胞,中断炎症反应链,可以达到控制疾病进展的目的。许多研究者将白细胞免疫吸附疗法应用于对重症炎症性肠病(SIBD)病人的治疗,并取得了一定的效果。这是对目前IBD治疗的补充,也是一种研究思路,但其吸附效果、疗效、不良反应等还有待进一步研究。 展开更多
关键词 免疫吸附技术 结肠炎 溃疡性 CROHN 单核细胞 中性白细胞 白细胞吸附疗法 炎症性肠病
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MRE检查对克罗恩病活动度的诊断价值
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作者 刘青 李瑾 +3 位作者 陈静云 魏佳 陈晓星 陈诗哲 《临床消化病杂志》 2019年第4期217-222,共6页
[目的]探讨血清学检查、内镜检查以及磁共振活动度指数(MRE)检查对克罗恩病(CD)活动度的诊断效率。[方法]纳入68例CD患者,收集其CRP、ESR、SES-CD评分、MaRIA评分、简化CDAI评分,分析上述指标对CD活动度的诊断效率。[结果]:总SES-CD对C... [目的]探讨血清学检查、内镜检查以及磁共振活动度指数(MRE)检查对克罗恩病(CD)活动度的诊断效率。[方法]纳入68例CD患者,收集其CRP、ESR、SES-CD评分、MaRIA评分、简化CDAI评分,分析上述指标对CD活动度的诊断效率。[结果]:总SES-CD对CD活动度的诊断率为76.6%,灵敏性62.5%,特异性83.3%,cut-off值为11.5;总MaRIA对CD活动度的诊断效率为71.2%,灵敏性80.0%,特异性67.6%,cut-off值为31.18;MaRIA最高分对CD活动度的诊断效率为65.5%,灵敏性63.5%,特异性79.4%,cut-off值为22.2;总MaRIA对中度活动度的诊断效率为77.9%,灵敏性83.3%,特异性71.2%,cut-off值为38.75;MaRIA最高分对中度活动度的诊断效率为69.8%,灵敏性66.7%,特异性67.3%,cut-off值为22.5(P<0.05)。[结论]MRE检查对CD活动度尤其是中度活动度的诊断效率较高。 展开更多
关键词 克罗恩病 简化内镜评分 磁共振肠动描记法 C反应蛋白 血沉 MaRIA
克罗恩病初诊患者贫血的临床特点 预览
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作者 王陆军 吴正祥 《临床医学研究与实践》 2019年第5期17-19,22共4页
目的研究克罗恩病(CD)初诊患者贫血的临床特点。方法选择我院2015年8月至2018年2月收治的122例初次确诊的CD患者为研究对象,分析住院CD患者的贫血情况,并探究贫血程度与CD蒙特利尔分型及大便隐血试验结果的关系;总结克罗恩病疾病活动指... 目的研究克罗恩病(CD)初诊患者贫血的临床特点。方法选择我院2015年8月至2018年2月收治的122例初次确诊的CD患者为研究对象,分析住院CD患者的贫血情况,并探究贫血程度与CD蒙特利尔分型及大便隐血试验结果的关系;总结克罗恩病疾病活动指数(CDAI)及CD简化内镜评分(SES-CD)与HGB、MCHC、MCH、MCV、RDW、ESR的关系。结果122例初次确诊CD患者中,有75.41%(92/122)的患者存在不同程度的贫血,以轻度贫血为主,无重度和极重度贫血;男女患者贫血比例为1.63∶1。不同贫血程度CD患者的大便隐血发生率无显著差异(P=0.261)。在CDAI中,轻度、中度活动期CD患者的MCH、MCV、ESR与缓解期比较,差异均具有统计学意义(P<0.05)。在SES-CD中,轻度、中度、重度活动期CD患者的HGB、MCH、MCHC、RDW与缓解期比较,差异均具有统计学意义(P<0.05)。结论CD患者以轻度贫血为主;CD患者贫血与肠道黏膜出血关系不大。通过对CD患者的MCH、MCV、ESR水平检测可对患者的疾病严重程度作出评估,通过HGB、MCHC、MCH、RDW检测可对CD患者肠道黏膜作出评估。 展开更多
关键词 克罗恩病 贫血 克罗恩病疾病活动指数 炎症活动度 CD简化内镜评分 红细胞体积指数
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重度克罗恩病的治疗进展 预览
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作者 刘元德 弓三东 《海南医学》 CAS 2019年第20期2691-2695,共5页
重度克罗恩病(Crohn’s disease,CD)是重度炎症性肠病(inflammatory bowel disease,IBD)的一种临床类型,病情顽固、迁延不愈。传统治疗药物对重度CD患者疗效不理想。近年来新型免疫抑制剂及生物制剂等方法的应用对重度CD的诱导缓解与维... 重度克罗恩病(Crohn’s disease,CD)是重度炎症性肠病(inflammatory bowel disease,IBD)的一种临床类型,病情顽固、迁延不愈。传统治疗药物对重度CD患者疗效不理想。近年来新型免疫抑制剂及生物制剂等方法的应用对重度CD的诱导缓解与维持治疗有了新的突破。本文从一般治疗、药物治疗、营养治疗、粪菌移植及手术治疗等方面着手,对重度CD的治疗进展作一探讨,重点阐述了新型免疫抑制剂及生物制剂的应用,充分显示出了它们的优越性和安全性,为医生合理制订临床治疗方案提供了更多选择。 展开更多
关键词 CROHN 炎症性肠病 治疗 免疫抑制剂 生物制剂
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Echovirus 18 Infection Is Associated with Crohn’s Disease 预览
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作者 John Chia Andrew Chia +3 位作者 David Wang Rabiha El-Habbal Sitaraman Jyotheeswaran Eric McCloud 《肠胃病学期刊(英文)》 2019年第8期174-183,共10页
Background: Enterovirus (EV) can cause gastroenteritis and are known to replicate in Peyer’s patches of terminal ileum. EV has been found in the intestinal specimens from immunocompromised patients with regional ente... Background: Enterovirus (EV) can cause gastroenteritis and are known to replicate in Peyer’s patches of terminal ileum. EV has been found in the intestinal specimens from immunocompromised patients with regional enteritis, and another study demonstrates the presence of enterovirus in the resected terminal ileum of immunocompetent pediatric patients with Crohn’s disease (CD). Cluster outbreaks of CD have also been reported in the literature but the cause of the disease remains elusive. Materials and Methods: A small cluster of pathologically proven CD occurred in our geographic area in 2004-2005, concurrently with an epidemic of Echovirus 18 (E18) meningitis. Serum samples of these and other CD patients and control subjects were tested for neutralizing antibodies of 11 common typeable enteroviruses and Echovirus 18;and tissue samples of CD patients, and terminal ileum and colon biopsies of normal controls were tested for the presence of viral capsid protein 1 (VP1) by immunoperoxidase staining. Results: Immunoperoxidase staining demonstrated VP1 in a rare epithelial granuloma, in diseased muscle of terminal ileum and also in colon biopsies of CD patients. Significantly elevated E18 neutralizing antibody was found in patients with pathologically-proven Crohn’s disease, as compared to control subjects. Conclusion: In this small observational study, EV VP1 is consistently demonstrated in tissue samples of CD patients as compared to control subjects;and neutralizing antibody for E18 was found in all of the patients with available serum samples. Larger cross-sectional studies will be needed to define the role of E18 in this chronic disease. 展开更多
关键词 ENTEROVIRUS Crohn’s Disease NEUTRALIZING ANTIBODY Immunoperoxidase STAINING
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MMP-7、SDC-1在炎症性肠病中的表达及其意义 预览
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作者 耿丽 王许平 +4 位作者 杨贝贝 王丹丹 高闯 杜晓博 冯百岁 《胃肠病学》 2019年第3期165-168,共4页
背景:基质金属蛋白酶-7(MMP-7)是MMPs家族中的一员,可表达于多种器官受损的黏膜上皮细胞中。多配体蛋白聚糖-1(SDC-1)是MMP-7的作用底物之一,在促进组织修复、维持肠屏障功能等方面发挥重要作用。目的:探讨MMP-7和SDC-1在炎症性肠病(IBD... 背景:基质金属蛋白酶-7(MMP-7)是MMPs家族中的一员,可表达于多种器官受损的黏膜上皮细胞中。多配体蛋白聚糖-1(SDC-1)是MMP-7的作用底物之一,在促进组织修复、维持肠屏障功能等方面发挥重要作用。目的:探讨MMP-7和SDC-1在炎症性肠病(IBD)中的表达及其意义。方法:收集郑州大学第二附属医院2017年1月—2018年1月住院活动期IBD患者的肠组织标本45例和外周血标本50例,同期非IBD肠组织标本30例和外周血标本35例作为对照组。采用免疫组化法检测肠组织MMP-7、SDC-1表达,ELISA法检测血清SDC-1含量。结果:MMP-7在IBD患者的肠组织中呈高表达,特别是溃疡边缘的肠上皮细胞。与对照组相比,IBD患者肠组织MMP-7表达增高、SDC-1表达降低,血清SDC-1含量增高,差异均有统计学意义(P<0.05)。Spearman相关系数分析显示,肠组织MMP-7表达与IBD疾病活动度呈显著正相关(溃疡性结肠炎:rs=0.519,P<0.05;克罗恩病:rs=0.583,P<0.05),与肠组织SDC-1表达呈显著负相关(rs=-0.646,P<0.05)。结论:MMP-7在IBD患者肠组织中表达增高,通过剪切SDC-1影响受损肠组织修复,参与IBD的发生、发展。 展开更多
关键词 炎症性肠病 结肠炎 溃疡性 CROHN 基质金属蛋白酶7 多配体蛋白聚糖1
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克罗恩病患者尿酸代谢变化及其潜在意义 预览
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作者 郭月凤 王承党 《胃肠病学》 2019年第9期557-560,共4页
正常人的尿酸(UA)2/3由肾脏代谢,1/3由肠道代谢,UA具有抗氧化、促氧化双重作用。属于非特异性胃肠道炎症性疾病的克罗恩病(CD)常合并肠外表现和全身代谢变化,UA代谢异常常见于CD患者,但其意义尚未阐明,给临床治疗带来困扰。本文就CD患... 正常人的尿酸(UA)2/3由肾脏代谢,1/3由肠道代谢,UA具有抗氧化、促氧化双重作用。属于非特异性胃肠道炎症性疾病的克罗恩病(CD)常合并肠外表现和全身代谢变化,UA代谢异常常见于CD患者,但其意义尚未阐明,给临床治疗带来困扰。本文就CD患者UA代谢变化及其潜在意义作一综述。 展开更多
关键词 炎症性肠病 CROHN 尿酸 代谢
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Harnessing the potential of gene editing technology using CRISPR in inflammatory bowel disease 预览
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作者 Viktor Limanskiy Arpita Vyas +1 位作者 Lakshmi Shankar Chaturvedi Dinesh Vyas 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第18期2177-2187,共11页
The molecular scalpel of clustered regularly interspersed short palindromic repeats/CRISPR associated protein 9 (CRISPR/Cas9) technology may be sharp enough to begin cutting the genes implicated in inflammatory bowel ... The molecular scalpel of clustered regularly interspersed short palindromic repeats/CRISPR associated protein 9 (CRISPR/Cas9) technology may be sharp enough to begin cutting the genes implicated in inflammatory bowel disease (IBD) and consequently decrease the 6.3 billion dollar annual financial healthcare burden in the treatment of IBD. For the past few years CRISPR technology has drastically revolutionized DNA engineering and biomedical research field. We are beginning to see its application in gene manipulation of sickle cell disease, human immunodeficiency virus resistant embryologic twin gene modification and IBD genes such as Gatm (Glycine amidinotransferase, mitochondrial), nucleotide-binding oligomerization domain-containing protein 2, KRT12 and other genes implicated in adaptive immune convergence pathways have been subjected to gene editing, however there are very few publications. Furthermore, since Crohn’s disease and ulcerative colitis have shared disease susceptibility and share genetic gene profile, it is paramount and is more advantageous to use CRISPR technology to maximize impact. Although, currently CRISPR does have its limitations due to limited number of specific Cas enzymes, off-target activity, protospacer adjacent motifs and crossfire between different target sites. However, these limitations have given researchers further insight on how to augment and manipulate enzymes to enable precise gene excision and limit crossfire between target sites. 展开更多
关键词 Clustered regularly interspersed short palindromic REPEATS INFLAMMATORY BOWEL DISEASE Crohn’s DISEASE Ulcerative colitis GENE excision GENE EDITING GENE therapy Financial impact of INFLAMMATORY BOWEL DISEASE on healthcare Clustered regularly interspersed short palindromic REPEATS crossfire
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Risk of inflammatory bowel disease in patients with chronic obstructive pulmonary disease:A nationwide,population-based study 预览
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作者 Jooyoung Lee Jong Pil Im +6 位作者 Kyungdo Han Seona Park Hosim Soh Kukhwan Choi Jihye Kim Jaeyoung Chun Joo Sung Kim 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第42期6354-6364,共11页
BACKGROUND There is a growing evidence regarding an increased risk of inflammatory bowel disease(IBD)among patients with airway diseases.AIM To investigate the influence of chronic obstructive pulmonary disease(COPD)o... BACKGROUND There is a growing evidence regarding an increased risk of inflammatory bowel disease(IBD)among patients with airway diseases.AIM To investigate the influence of chronic obstructive pulmonary disease(COPD)on the risk of IBD.METHODS A nationwide,population-based study was conducted using data from the National Health Insurance Service database.A total of 1303021 patients with COPD and 6515105 non-COPD controls were identified.The COPD group was divided into the severe and the mild COPD group according to diagnostic criteria.The risk of IBD in patients with COPD compared to controls was analyzed by Cox proportional hazard regression models.The cumulative incidences of IBD were compared between the groups.RESULTS The COPD group had higher incidences of IBD compared to non-COPD controls(incidence rate,9.98 vs 7.18 per 100000 person-years,P<0.001).The risk of IBD in the COPD group was increased by 1.38(adjusted hazard ratio(HR);95%CI:1.25-1.52).The incidence rate of IBD was higher in the severe COPD group than in the mild COPD group(12.39 vs 9.77 per 100000 person-year,P<0.001).The severity of COPD was associated with an increased risk of IBD(adjusted HR 1.70 in severe COPD,95%CI:1.27-2.21 and adjusted HR 1.35 in mild COPD,95%CI:1.22-1.49)CONCLUSION The incidences of IBD were significantly increased in COPD patients in South Korea and the risk of developing IBD also increased as the severity of COPD increased. 展开更多
关键词 Claim data Inflammatory bowel disease Chronic obstructive pulmonary disease Crohn’s disease Ulcerative colitis
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炎症性肠病病人患病体验质性研究的Meta-整合 预览
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作者 卜凡莉 黄骞 +2 位作者 王珂 黄迎春 彭南海 《护理研究》 北大核心 2019年第5期754-761,共8页
[目的]系统分析炎症性肠病病人的患病体验。[方法]检索The Cochrane Library、PubMed、Medline、Web of Science、中国知网、万方和维普数据库,纳入炎症性肠病病人患病体验相关的质性研究,在进行质量评价之后进行整合与分析。[结果]共纳... [目的]系统分析炎症性肠病病人的患病体验。[方法]检索The Cochrane Library、PubMed、Medline、Web of Science、中国知网、万方和维普数据库,纳入炎症性肠病病人患病体验相关的质性研究,在进行质量评价之后进行整合与分析。[结果]共纳入15篇相关文献,将研究结果重新归纳分类,得出7个主题:对炎症性肠病的认识、沉重的心理压力、与疾病周旋、自我概念的改变、应对炎症性肠病的方式、自我调整与寻求帮助、信息支持与情感支持。[结论]炎症性肠病病人的患病体验较为复杂,沉重的心理压力和需要支持是较为显著的体验,个体化的心理干预、专业的疾病信息支持和良好的社会支持十分重要。 展开更多
关键词 炎症性肠病 克罗恩病 溃疡性结肠炎 患病体验 质性研究 心理压力 社会支持 Meta-整合
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Comparison of the use of wireless capsule endoscopy with magnetic resonance enterography in children with inflammatory bowel disease 预览
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作者 Nadia Mazen Hijaz Thomas Mario Attard +2 位作者 Jennifer Marie Colombo Neil Joseph Mardis Craig Alan Friesen 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第28期3808-3822,共15页
BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) a... BACKGROUND Magnetic resonance enterography (MRE) and wireless capsule endoscopy (WCE) are equally accepted modalities for noninvasive screening of small bowel involvement (SBI) in children with Crohn’s disease (CD) and indeterminate colitis (IC) albeit there is a paucity of data comparing the two and thereby guiding the clinician in selecting the ideal diagnostic approach. Therefore, the goal of this study is to provide additional evidence for capsule endoscopy role in the evaluation of established Crohn’s disease exacerbation compared to MRE in relation to Pediatric Crohn's Disease Activity Index (PCDAI), and histological indices. AIM To prospectively compare the findings of MRE and WCE and their agreement with PCDAI or histology in children with CD or IC. METHODS Consecutive patients diagnosed with CD and IC were screened for inclusion. After informed consent, patient’s demographic and clinical data was abstracted. The current pediatric disease activity index (PCDAI) and endoscopic findings were included. Patients underwent MRE and WCE including preprocedural patency capsule within a maximum of 7 d of each other. Pathological presence of active small bowel disease in ileal and duodenal biopsies were collected if the endoscopy was performed within 2 mo of the WCE study. Patients who failed to pass the PC were excluded from the study. WCE was read by two different experienced gastroenterologists (Attard TM and Colombo JM) blinded to each other's findings and to the findings on MRE (Mardis NJ). Agreement between WCE reviewers, WCE and MRE findings and concordance between positive PCDAI and SBI based on MRE compared with WCE was computed. RESULTS Forty-five patients were included in the study, 18 withdrew and 27 (20 males and 20 CD), mean age (standard deviation) 13.46 (2.4) years, completed the study protocol. There were no instances of capsule retention. Concordance between gastroenterologist reviewers was excellent for the diagnosis of small intestinal CD with good correlation between the two Lewis scores 展开更多
关键词 Crohn’s DISEASE Wireless capsule endoscopy Inflammatory BOWEL DISEASE Magnetic resonance ENTEROGRAPHY SMALL BOWEL involvement SMALL BOWEL DISEASE INDETERMINATE colitis Pediatric CHILDREN
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炎症性肠病肺部表现的研究进展 预览
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作者 刘宇 罗娟 缪应雷 《中国当代医药》 2019年第15期23-27,共5页
炎症性肠病(IBD)是肠道的慢性非特异性炎症性疾病.其肠外表现复杂多样,涉及多个系统.肺部表现作为其中一个类型并不常见,在临床工作中容易被轻视,其主要包括IBD肺部表现的亚临床改变、药物相关性肺部病变和非药物引起的肺部病变.本文就... 炎症性肠病(IBD)是肠道的慢性非特异性炎症性疾病.其肠外表现复杂多样,涉及多个系统.肺部表现作为其中一个类型并不常见,在临床工作中容易被轻视,其主要包括IBD肺部表现的亚临床改变、药物相关性肺部病变和非药物引起的肺部病变.本文就IBD的肺部表现的研究进展进行综述,以期更全面地认识IBD并指导临床诊疗. 展开更多
关键词 炎症性肠病 溃疡性结肠炎 克罗恩病 肺部疾病
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内镜活检Crohn病的临床病理分析 预览
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作者 黄薇 杨通 关晓颖 《广州医药》 2019年第1期52-56,共5页
目的探讨内镜活检Crohn病(CD)的临床病理特征,为临床提供更可靠的诊断。方法回顾性分析内镜活检12例CD的临床表现、内窥镜特征,采用HE染色及免疫组化EnVision二步法。结果显微镜下CD的组织学形态主要特征是非干酪样坏死性肉芽肿、裂隙... 目的探讨内镜活检Crohn病(CD)的临床病理特征,为临床提供更可靠的诊断。方法回顾性分析内镜活检12例CD的临床表现、内窥镜特征,采用HE染色及免疫组化EnVision二步法。结果显微镜下CD的组织学形态主要特征是非干酪样坏死性肉芽肿、裂隙状溃疡、黏膜及黏膜下层不均匀分布的重度炎症,淋巴管扩张和纤维组织增生,免疫组化染色CD68、D2-40、S-100均表达。结论CD是一肿少见的炎症性肠病,回盲部及末段回肠是最好发部位,主要表现反复腹泻、血便等症状,内镜下见多灶溃疡,不连续性病变等特征,组织学见裂隙性溃疡,黏膜及黏膜下层的重度炎症且不均匀分布,位于生发中心的非干酪结节病样肉芽肿、淋巴管扩张和纤维组织增生等非特异性特征,可靠的病理诊断要结合临床、内镜、影像等检查及多部位多次活检。 展开更多
关键词 CROHN 内镜活检 肉芽肿 裂隙状溃疡 免疫组织化学
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磁共振肠道造影对炎性肠病的诊断价值
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作者 叶心然 廖坚 +1 位作者 叶斌 张声旺 《中国医师杂志》 CAS 2019年第6期862-865,871共5页
目的探讨磁共振肠道造影(MRE)在炎性肠病(IBD)中的诊断效能和图像质量的评估。方法回顾性分析在湘雅三医院拟诊为炎性肠病并行MRE检查的132例患者。将患者的MRE表现与手术及内窥镜获得的组织病理学结果进行比较,计算灵敏度、特异度和诊... 目的探讨磁共振肠道造影(MRE)在炎性肠病(IBD)中的诊断效能和图像质量的评估。方法回顾性分析在湘雅三医院拟诊为炎性肠病并行MRE检查的132例患者。将患者的MRE表现与手术及内窥镜获得的组织病理学结果进行比较,计算灵敏度、特异度和诊断符合率。并使用四分法评估MRE的图像质量。结果 MRE诊断炎性肠病的灵敏度、特异度和诊断符合率分别为94. 3%、92. 6%和93. 9%,其中2例患者假阳性,6例患者假阴性。根据评估标准一共评估了 530个小肠段MRE图像质量。其中,323个(61%)的图像质量得分为1,170个(32%)得分为2,29个(5.5%)得分为3,8个(1.5%)得分为4。观察者对所有肠管节段的图像质量评分和IBD评估的一致性很好(κ=0.73),远端回肠(1. 12)和末端回肠(1. 15)的区段中图像质量分数最高,十二指肠(1.92)和空肠(1.6)段的图像质量分数最低。结论 MRE在诊断炎性肠病中具有较高的诊断符合率,并能提供优异的图像质量。 展开更多
关键词 炎性肠疾病 结肠炎 溃疡性 CROHN 造影剂 X线透视检查 磁共振成像
抑郁程度和社会支持对克罗恩病患者述情障碍的影响分析
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作者 董正椽 赵婉毅 孙菁 《上海医学》 CAS 北大核心 2019年第5期257-262,共6页
目的分析抑郁程度与社会支持对克罗恩病(CD)患者述情障碍的影响。方法采用一般资料调查表、多伦多述情障碍量表(TAS-26)、Beck抑郁问卷和社会支持评定量表,对119例CD患者的一般资料、述情障碍、抑郁、社会支持情况进行测评与分析。采用P... 目的分析抑郁程度与社会支持对克罗恩病(CD)患者述情障碍的影响。方法采用一般资料调查表、多伦多述情障碍量表(TAS-26)、Beck抑郁问卷和社会支持评定量表,对119例CD患者的一般资料、述情障碍、抑郁、社会支持情况进行测评与分析。采用Pearson相关分析探讨CD患者述情障碍与抑郁和社会支持之间的关系。结果 CD患者述情障碍的总分为(79.85±10.87)分,4个维度得分情况分别为述情障碍(17.21±3.98)分、认识和区分情感与躯体感受障碍(21.36±4.40)分、缺乏幻想(16.04±3.32)分、外向性思维(25.24±6.09)分。CD患者抑郁的总分为(11.08±8.78)分,社会支持的总分为(35.63±6.71)分。相关性分析结果显示,CD患者述情障碍总分与抑郁总分呈正相关(r=0.212,P=0.010),与社会支持中客观支持维度呈负相关(r=-0.241,P=0.004)。结论 CD患者的抑郁严重程度越高,述情障碍严重程度也越高;社会支持程度越高,述情障碍严重程度越低。 展开更多
关键词 CROHN 抑郁 社会支持 医务社会工作 述情障碍
超声造影在克罗恩病中的研究进展 预览
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作者 马千清 龚儒杰(综述) 江峰(审校) 《重庆医学》 CAS 2019年第16期2830-2833,共4页
克罗恩病(CD)是一种终身疾病,病因不明,分缓解期及活动期,不同时期的治疗方案不同。手术后再手术率很高,需要长期反复监测。超声做为一项无创性检查在CD的检查和随访中有着很突出的优势,造影剂的引入大大提高了超声诊断CD的准确性。本... 克罗恩病(CD)是一种终身疾病,病因不明,分缓解期及活动期,不同时期的治疗方案不同。手术后再手术率很高,需要长期反复监测。超声做为一项无创性检查在CD的检查和随访中有着很突出的优势,造影剂的引入大大提高了超声诊断CD的准确性。本文探讨超声造影在CD中的应用研究进展。 展开更多
关键词 超声检查 多普勒 彩色 CROHN 综述
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