大连炎症性肠疾病（IBD）皮质类固醇治疗与血栓有关
炎症性肠疾病（IBD）皮质类固醇治疗与血栓有关
研究人员发现，应用皮质类固醇治疗IBD能显著提高血栓在这些患者中的发病风险。
根据这项研究结果，应用类固醇药物治疗的IBD患者是应用生物药物治疗的患者静脉血栓（VTE）发生率的5倍。研究人员说，服用高剂量皮质类固醇的患者发生VTE的风险更高，这支持了类固醇类药物，就像雌激素一样，具有促进形成血栓的作用的说法。此研究结果发表在2015年2月份的Clinical Gastroenterology and Hepatology(13:316-321)。
这项由Michigan大学胃肠病专家进行的研究筛查了超过15000例成年IBD患者的病例。为了符合分析，没有一例患者先前被诊断为VTE。
在过去7年的研究期间，记录了325例发生VTE患者。在这些患者中，2.25%发生在只服用皮质类固醇药物的患者中，0.44%发生在只服用生物药物的患者中，2.49%发生在同时接受以上2种药物治疗的患者中。
只服用生物制剂的患者VTE的发生率是只服用皮质类固醇药物患者的0.21。“皮质类固醇和生物制剂联合治疗与单独服用皮质类固醇的患者VTE风险相同，”研究人员写到，“似乎皮质类固醇提高了VTE的发生率。”
本文由消化界翻译，转载请注明出处。来源：gastroendonews.com
英文原文：
The use of corticosteroids to treat inflammatory boweldisease (IBD) significantly increases the risk for blood clots in thesepatients, researchers have found.
Patients with IBD who take steroids are five times more likely to developvenous thromboembolism (VTE) than those who take biologic medications, according to the study. The risk is greater for patients taking high doses ofcorticosteroids, supporting the notion that steroids, like estrogens, have aprothrombotic effect, the researchers said. The findings appear in the February2015 issue of Clinical Gastroenterology and Hepatology (13:316-321).
The study, led by gastroenterologists at the University of Michigan, examined medical records of more than 15,000 adults with IBD. To qualify for theanalysis, none of the patients could have had a previous diagnosis ofVTE.
Over the seven-year study period, 325 incidents of VTE were recorded. Of those,2.25% occurred in patients taking only corticosteroids, 0.44% in patientstaking only biologic agents and 2.49% in patients receiving both classes ofmedication.
The odds of VTE for patients taking biologic therapy alone was 0.21 that forpatients taking corticosteroids only. “Combination therapy with corticosteroidsand biologic agents was associated with the same risk for VTE as that ofcorticosteroids alone,” the researchers wrote. “Corticosteroids, therefore,appear to increase risk for VTE.”
我是医生 说给你听
肖祥斌 胃肠科主任医师
→ 咨询给胃炎患者的几点意见：胃炎一般分为内痔、外痔和混合痔三种，而内痔又有一、二、三、四度之分，选择治疗方法必须根据患痔类型、轻重程度具体决定。如对症状较轻的一度、二度内痔可以选择药物治疗，而对早期血栓性外痔来说，手术治疗效果要比用药好。
程芳 女性胃肠主任
→ 咨询给胃炎患者的几点意见：注意饮食，忌酒和辛辣刺激食物，增加纤维性食物，多摄入果蔬、多饮水，改变不良的排便习惯，保持大便通畅，必要时服用缓泻剂，便后清洗肛门。对于脱垂型痔，注意用手轻轻托回痔块，阻止再脱出。避免久坐久立，进行适当运动。
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