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JAMA:炎症性肠炎患者治疗方案与淋巴瘤风险关系研究

2017-11-08 zhangfan MedSci原创

对于成年炎症性肠炎患者,接受巯嘌呤或肿瘤坏死因子抑制剂单药可略微但具有统计学意义地增加淋巴瘤风险,但二者联用则导致患者淋巴瘤风险显著增加

研究发现接受巯嘌呤治疗的炎症性肠病(IBD)患者其淋巴瘤风险增加。近日研究人员考察了接受抗肿瘤坏死因子(TNF)抑制剂单独或联合巯嘌呤治疗IBD患者的淋巴瘤风险。

研究人员对法国全民健康保险数据库资料进行分析,18岁以上的IBD患者参与,患者依据治疗方案分层:巯嘌呤单药治疗、抗肿瘤坏死因子抑制剂单药治疗、联合治疗以及未治疗。研究的主要终点是淋巴瘤。

总计189289名IBD患者参与研究,其中女性占54%,患者平均年龄43岁,平均随访6.7年。随访中123069名患者未接受治疗,50405名患者服用巯嘌呤单药治疗、30294名患者接受抗肿瘤坏死因子抑制剂单药治疗、14229人接受联合治疗。总计发生了336例淋巴瘤,其中未经治疗组220例(每1000患者年的发病率为0.26,95% CI, 0.23-0.29),巯嘌呤单药治疗组70例(发病率为0.54; 95% CI, 0.41-0.67),抗TNF治疗组32例(发病率, 0.41; 95% CI, 0.27-0.55),联合治疗组14例(发病率为, 0.95; 95% CI, 0.45-1.45)。多因素Cox分析显示,相对于未经治疗组,巯嘌呤单药治疗组,抗TNF治疗组以及联合治疗组的淋巴瘤风险分别为2.60、2.41以及6.11。联合治疗组患者淋巴瘤风险高于单药治疗组。

研究认为,对于成年炎症性肠炎患者,接受巯嘌呤或肿瘤坏死因子抑制剂单药可略微但具有统计学意义地增加淋巴瘤风险,但二者联用则导致患者淋巴瘤风险显著增加。

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    2017-11-08 小雨的大侠

    学习了.学习分享

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    2017-11-08 半夏微凉

    学习了谢谢分享

    0

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