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Resistance to activated protein C is a risk factor for fibrostenosis in Crohn’s disease

World Journal of Gastroenterology 2006年第37期12卷 6026-6031页

作者： Gottfried Novacek Wolfgang Miehsler julia palkovits Walter Reinisch Thomas Waldhr Center of Public Health Department of Epidemiology Medical University of Vienna Vienna Austria Stylianos Kapiotis Alfred Gangl Harald Vogelsang Department of Internal Medicine Ⅳ Division of Gastroenterology andHepatology Medical University of Vienna Vienna Austria Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical University of Vienna Vienna Austria

AIM: To evaluate the effect of resistance to activated protein C (aPCR), the most common known inherited thrombophilic disorder, on the risk of intestinal operation of fi brostenosis in patients with Crohn’s disease (CD). METHODS: In a previous study, we assessed the prevalence of aPCR in CD. In a retrospective case- controlled study, 8 of these CD patients with aPCR were now compared with 24 CD patients without aPCR, matched by gender, age at diagnosis and duration of disease in a 1:3 fashion. The primary end point was the occurrence of an intestinal CD-related operation with evidence of fibrostenosis in the bowel resection specimen. RESULTS: The Kaplan-Meier analysis revealed that patients with aPCR had a lower probability of remaining free of operation with f ibrostenosis than patients without aPCR (P = 0.0372; exact log-rank test) resulting in a signifi cantly shorter median time interval from diagnosis of CD to the fi rst operation with fi brostenosis (32 vs 160 mo). At 10 years, the likelihood of remaining free of operation with fi brostenosis was 25% for patients with aPCR and 57.8% for patients without aPCR. CONCLUSION: CD patients with aPCR are at higher risk to undergo intestinal operation of fi brostenosis than those without aPCR. This supports our hypothesis of aPCR being a possible risk factor for fi brostenosis in CD.

关键词： Fibrostenosis Resistance to activated protein C Factor V Leiden Intestinal surgery Crohn's disease

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