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Increased risk of atrial fibrillation in patients with inflammatory bowel disease: A nationwide population-based study

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World Journal of Gastroenterology 2019年第22期25卷 2788-2798页

作者： You-Jung Choi Eue-Keun Choi Kyung-Do Han Jiesuck Park Inki Moon Euijae Lee Won-Seok Choe So-Ryoung Lee Myung-Jin Cha Woo-Hyun Lim Seil Oh Department of Internal Medicine Seoul National University HospitalSeoul 03080South Korea Department of Biostatistics College of MedicineThe Catholic University of KoreaSeoul 03083South Korea Department of Internal Medicine Seoul National University Boramae Medical CenterSeoul 07061South Korea

BACKGROUND Inflammatory bowel disease (IBD), a chronic inflammatory disease of the gastrointestinal tract, could play a role in the pathophysiology of atrial fibrillation (AF). AIM To investigate the association between IBD and AF development. METHODS We performed a population-based cohort study using records in the Korean National Health Insurance Services database between 2010 and 2014. A total of 37696 patients with IBD (12349 with Crohn’s disease and 25397 with ulcerative colitis) were identified. The incidence rate of newly diagnosed AF in patients with IBD was compared with that in a 3 times larger cohort of 113088 age- and sex-matched controls without IBD. RESULTS During 4.9 ± 1.3 years of follow-up, 1120 patients newly diagnosed with AF (348 in the IBD group and 772 in controls) were identified. After adjustments using multivariable Cox proportional hazards, patients with IBD were at a 36%[95% confidence interval (CI) 20%-54%] higher risk of AF than controls. The association between IBD and the development of AF was stronger in younger than in older patients. Patients without cardiovascular risk factors showed a higher risk of AF primarily. Additionally, patients receiving immun-omodulators [Hazard ration (HR) 1.46, 95%CI 1.31-1.89], systemic corticosteroids (HR 1.37, 95%CI 1.10-1.71), or biologics agents (HR 2.38, 95%CI 1.51-3.75) were at higher risk of AF than patients without them. CONCLUSION IBD significantly increased the risk of AF, and the impact of IBD on developing AF was in patients with moderate to severe disease.

关键词： Atrial fibrillation Inflammatory bowel disease colitis, Ulcerative Crohn's disease

Inflammatory　bowel　disease　in　Hubei　Province　of　China

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World Journal of Gastroenterology 1997年第2期3卷 62-63页

作者： XIA Bing 1, S. SHIVANANDA 2, ZHANG Gui Shui 1, YI Ji Yun 1, JBA CRUSIUS 3 and AS PE N～ A 3

AIM To investigate the inpatients with inflammatory bowel disease admitted to The Second Hospital, Hubei Medical University from 1986 to 1995 and analyze clinical features and follow up results of the patient in Hubei region. METHODS Data was collected retrospectively from 74 patients with inflammatory bowel disease (66 patients with ulcerative colitis and 8 patients with Crohn′s disease) hospitalized in The Second Hospital, Hubei Medical University from 1986 to 1995. RESULTS Abdominal pain, diarrhea, bloody and mucus stool and constipation are commonest symptoms of inflammatory bowel disease. Extraintestinal diseases were not common. The disease was mainly located in sigmoid and left colon in ulcerative colitis and located in ileum and colon in Crohn′s disease. Sulphasalazine and corticosteroid were effective (95%) in the treatment of ulcerative colitis, but about 42% patients had recurrence during the follow up of 1 11 years. Of 8 patients with Crohn′s disease, 5 had partial intestinal removal, and 3 treated with medicine of anti tuberculosis or metronidazole. Of 4 patients followed up for 1～8 years, 1 patient died of severe complications after surgery, 2 had recurrence with the medicine and 1 maintained remission with the treatment of sulphasalazine after operation. CONCLUSION From our data, family history of inflammatory bowel disease was seen in 5%. About 34% patients were smoking and 32% patients were alcoholic. Epidemiological investigation is urgently needed in Hubei of China to judge the strength of genetics and environmental factors in the pathogenesis of inflammatory bowel diseases.

关键词： colitis, ulcerative Crohn′s disease

Current concepts of the pathogenesis of IBD

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World Journal of Gastroenterology 1998年第S1期4卷 28-30页

Ｏｖｅｒｔｈｅｐａｓｔｄｅｃａｄｅ，ｔｈｅｆｏｃｕｓｏｆｔｈｅｅｔｉｏｐａｔｈｏｇｅｎｅｓｉｓｏｆｃｈｒｏｎｉｃｉｎｆｌａｍｍａｔｏｒｙｂｏｗｅｌｄｉｓｅａｓｅ（ＩＢＤ）ｈａｓｔｕｒｎｅｄｔｏｗａｒｄｄｅｆｉｎｉｎｇ...

Ｏｖｅｒｔｈｅｐａｓｔｄｅｃａｄｅ，ｔｈｅｆｏｃｕｓｏｆｔｈｅｅｔｉｏｐａｔｈｏｇｅｎｅｓｉｓｏｆｃｈｒｏｎｉｃｉｎｆｌａｍｍａｔｏｒｙｂｏｗｅｌｄｉｓｅａｓｅ（ＩＢＤ）ｈａｓｔｕｒｎｅｄｔｏｗａｒｄｄｅｆｉｎｉｎｇａｄｅｆｉｃｉｔｉｎｉｍｍｕｎｅｒ...

关键词： inflammatory bowel disease/etiology inflammatory bowel disease/pathology inflammatory bowel disease/immunology Crohn′s disease colitis, ulcerative

Epidemiology and disease outcome in inflammatory bowel disease:observations from the European Collaborative Study

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World Journal of Gastroenterology 1998年第S1期4卷 33-34页

ＩＮＴＲＯＤＵＣＴＩＯＮＥｐｉｄｅｍｉｏｌｏｇｙｉｓｃｏｎｃｅｒｎｅｄｗｉｔｈｔｈｅｓｔｕｄｙｏｆｄｉｓｔｒｉｂｕｔｉｏｎａｎｄｄｅｔｅｒｍｉｎａｎｔｓｏｆｄｉｓｅａｓｅｉｎｔｈｅｐｏｐｕｌａｔｉｏｎ．Ｉｔｃａｎｂｅ...

ＩＮＴＲＯＤＵＣＴＩＯＮＥｐｉｄｅｍｉｏｌｏｇｙｉｓｃｏｎｃｅｒｎｅｄｗｉｔｈｔｈｅｓｔｕｄｙｏｆｄｉｓｔｒｉｂｕｔｉｏｎａｎｄｄｅｔｅｒｍｉｎａｎｔｓｏｆｄｉｓｅａｓｅｉｎｔｈｅｐｏｐｕｌａｔｉｏｎ．Ｉｔｃａｎｂｅａｌｓｏａｐｐｌｉｅｄｔｏｓｔｕｄ...

关键词： inflammatory bowel diseases/epidemiology colitis, ulcerative Crohn’s disease

Inflammatory pouch disease: The spectrum of pouchitis

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World Journal of Gastroenterology 2015年第29期21卷 8739-8752页

作者： Petros Zezos Fred Saibil Division of Gastroenterology Department of Medicine Sunnybrook Health Sciences Centre University of Toronto

Restorative proctocolectomy with ileal-pouch anal anastomosis(IPAA) is the operation of choice for medically refractory ulcerative colitis(UC), for UC with dysplasia, and for familial adenomatous polyposis(FAP). IPAA can be a treatment option for selected patients with Crohn's colitis without perianal and/or small bowel disease. The term "pouchitis" refers to nonspecific inflammation of the pouch and is a common complication in patients with IPAA; it occurs more often in UC patients than in FAP patients. This suggests that the pathogenetic background of UC may contribute significantly to the development of pouchitis. The symptoms of pouchitis are many, and can include increased bowel frequency, urgency, tenesmus, incontinence, nocturnal seepage, rectal bleeding, abdominal cramps, and pelvic discomfort. The diagnosis of pouchitis is based on the presence of symptoms together with endoscopic and histological evidence of inflammation of the pouch. However, "pouchitis" is a general term representing a wide spectrum of diseases and conditions, which can emerge in the pouch. Based on the etiology we can sub-divide pouchitis into 2 groups: idiopathic and secondary. In idiopathic pouchitis the etiology and pathogenesis are still unclear, while in secondary pouchitis there is an association with a specific causative or pathogenetic factor. Secondary pouchitis can occur in up to 30% of cases and can be classified as infectious, ischemic, non-steroidal antiinflammatory drugs-induced, collagenous, autoimmuneassociated, or Crohn's disease. Sometimes, cuffitis or irritable pouch syndrome can be misdiagnosed as pouchitis. Furthermore, idiopathic pouchitis itself can be sub-classified into types based on the clinical pattern, presentation, and responsiveness to antibiotic treatment. Treatment differs among the various forms of pouchitis. Therefore, it is important to establish the correct diagnosis in order to select the appropriatetreatment and further management. In this editoria

关键词： Pouchitis Idiopathic pouchitis Secondarypouchitis Ulcerative colitis, Crohn's disease