Chronisch entzündliche Darmerkrankungen – die Lunge im Blick behalten

M. Polke
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Abstract

Background: No large, prospective study has investigated respiratory symptoms in patients with inflammatory bowel diseases. We aimed to describe the prevalence of and factors associated with respiratory symptoms in patients with inflammatory bowel disease. Methods: In an observational, prospective, cross-sectional study, we evaluated the frequency of respiratory symptoms using a validated self-reporting questionnaire from February 2019 to February 2021 during routine follow-up outpatient visits of patients with inflammatory bowel disease followed in the Gastroenterology Department of the Nancy University Hospital. In case of a positive questionnaire, patients were systematically offered a consultation with a pulmonologist in order to investigate a potential underlying respiratory disease. Results: There were 325 patients included, and 180 patients had a positive questionnaire (144 with Crohn’s disease). Of the included patients, 165 (50.8%) presented with respiratory symptoms, with dyspnea being the most frequent symptom (102 patients). There were 102 patients (56.7%) who benefited from a consultation in the pulmonology department: 43 (42.2%) were diagnosed with a respiratory disease, mainly asthma (n = 13) or chronic obstructive pulmonary disease (n = 10). Fourteen patients (13.7%) had obstructive sleep apnea. A body mass index increase, being a smoker or ex-smoker, and having articular extra-intestinal manifestations were independently associated with a higher prevalence of respiratory symptoms. Conclusions: Half of patients with inflammatory bowel disease reported respiratory symptoms in our study. Patients with inflammatory bowel disease should be systematically screened, as pulmonary disease is frequently present in this population, with specific attention being given to smokers or ex-smokers and patients with extra-articular intestinal manifestations.
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慢性痢疾注意肺部
背景:没有大型前瞻性研究调查炎症性肠病患者的呼吸道症状。我们的目的是描述炎症性肠病患者的患病率和与呼吸道症状相关的因素。方法:在一项观察性、前瞻性、横断面研究中,我们在2019年2月至2021年2月期间,在南希大学医院消化内科对炎症性肠病患者进行常规随访门诊期间,使用经过验证的自我报告问卷评估呼吸道症状的频率。如果问卷调查呈阳性,则系统地向患者提供肺科医生的会诊,以调查潜在的呼吸道疾病。结果:共纳入325例患者,180例问卷调查阳性(其中144例为克罗恩病)。在纳入的患者中,165例(50.8%)出现呼吸系统症状,以呼吸困难为最常见症状(102例)。102例患者(56.7%)从肺科就诊中受益:43例(42.2%)被诊断患有呼吸系统疾病,主要是哮喘(n = 13)或慢性阻塞性肺疾病(n = 10)。14例(13.7%)存在阻塞性睡眠呼吸暂停。体重指数增加、吸烟者或戒烟者以及有关节外肠道表现与呼吸道症状的较高患病率独立相关。结论:在我们的研究中,一半的炎症性肠病患者报告了呼吸道症状。炎症性肠病患者应进行系统筛查,因为肺部疾病在这一人群中经常出现,尤其要注意吸烟者或戒烟者以及有关节外肠道表现的患者。
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