炎症性肠病患者10年后常患脊椎关节病

柏林(EGMN)——根据首项分析炎症性肠病(IBD)患者的脊椎关节病发病情况的人群研究结果，在诊断IBD后10年内，脊椎关节病的累计发病率为1/50，在诊断IBD后20和30年，发病率分别攀升到1/25和1/14。

明尼苏达州罗彻斯特市梅奥医院风湿科主任Matteson医生及其同事分析了明尼苏达州Olmsted县1970~2004年间被诊断为IBD的居民的医疗记录。有311人被诊断为克罗恩氏病，365人被诊断为溃疡性结肠炎，对这些患者随访至2011年6月。诊断IBD时的中位年龄为33岁。

结果显示，在IBD之前被诊断为脊椎关节病的比例为1%。在确诊IBD后10年、20年和30年，脊椎关节病的累计发病率分别为2.3%、4.2%和7.1%。诊断IBD后10年时，强直性脊柱炎的累计发病率为0.2%，在诊断后20年升至0.7%。在诊断克罗恩氏病后10、20和30年，脊椎关节病的累计发病率分别为2.6%、6.1%和 9.8%；在诊断溃疡性结肠炎后10、20和30年，脊椎关节病的累计发病率分别为1.9%、2.8%和4.9%。

诊断IBD后才出现的脊椎关节病临床特征包括：少关节炎(3.1%)、多关节炎(1.3%)、骶髂关节炎(1.6%)、银屑病(2.2%)、葡萄膜炎(2.9%)、足底筋膜炎(5%)。

Matteson医生披露无相关利益冲突。

爱思唯尔  版权所有

BY BRUCE JANCIN
Elsevier Global Medical News
Breaking News

BERLIN (EGMN) – The cumulative incidence of spondyloarthropathy in the first decade after diagnosis of inflammatory bowel disease is about 1 in 50 patients, climbing to 1 in 25 at 20 years and 1 in 14 at 30 years, according to the first population-based study to scrutinize the issue.

The incidence of spondyloarthropathy following diagnosis of ulcerative colitis is about half that seen in Crohn’s disease patients, said Dr. Eric L. Matteson at the Annual European Congress of Rheumatology.

Dr. Matteson, a professor of medicine and chair of the department of rheumatology at the Mayo Clinic, Rochester, Minnesota, and his coinvestigators analyzed the medical records of Olmsted County, Minnesota, residents who had been diagnosed with inflammatory bowel disease (IBD) during 1970-2004. The 311 patients diagnosed with Crohn’s disease and 365 with ulcerative colitis were followed longitudinally through June 2011. The median age at diagnosis of IBD was 33 years.

The prevalence of diagnosed spondyloarthropathy prior to diagnosis of IBD was 1%. The cumulative incidence of spondyloarthropathy following an established IBD diagnosis was 2.3% at 10 years, 4.2% at 20 years, and 7.1% at 30 years. The overall cumulative incidence of ankylosing spondylitis was 0.2% at 10 years, rising to 0.7% at 20 years.

The 10-, 20- and 30-year cumulative incidence rates for spondyloarthropathy after diagnosis of Crohn’s disease were 2.6%, 6.1%, and 9.8%, respectively, as compared with 1.9%, 2.8%, and 4.9% following diagnosis of ulcerative colitis.

Clinical features of spondyloarthropathy that appeared only after diagnosis of IBD included oligoarthritis in 3.1%, polyarthritis in 1.3%, sacroiliitis in 1.6%, psoriasis in 2.2%, uveitis in 2.9%, and plantar fasciitis in 5%.

Dr. Matteson reported having no financial conflicts.