囊性纤维化住院患者消化性溃疡发病率低:一项国家数据库研究。

Maya Mahmoud, Eugene Nwankwo, Zidong Zhang, Neel Matiwala, Rohan Tripathi, Islam Mohamed, Christopher Barrios, Wing-Kin Syn, Christine Hachem
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摘要

背景:尽管囊性纤维化(CF)被普遍认为是一种肺部疾病,但CF特有的胃肠道症状和疾病的发病率却在持续上升。消化性溃疡病(PUD)在囊性纤维化患者(PwCF)中尚未得到充分研究,但可能是导致腹部症状的常见原因。在 PwCF 患者中,碳酸氢盐分泌受损和胃酸分泌不足是导致溃疡发生的原因,但溃疡仍不常见。本研究旨在评估 PwCF 中 PUD 的患病率,并评估可能的诱因:本研究利用了全国住院病人抽样(NIS)数据库。2014年至2019年期间,所有18岁或18岁以上的CF患者均被确定。使用 ICD-9 和 ICD-10 编码确定了相关的患者特征和手术。进行了线性趋势分析、双变量分析和多元回归分析。相关结果为消化性溃疡病、胰腺功能不全和非酒精性脂肪性肝炎或 NASH。所有分析均考虑了国家健康调查的复杂抽样方案:全国住院病人抽样(NIS)数据库中PwCF的总患病率为0.08%,从2014年到2019年,这一数字逐年稳定。西班牙裔患者比其他白人更有可能被诊断为PUD(aOR 1.802 [1.311,2.476] )。多元回归分析表明,PwCF 中的 PUD 与 NASH 诊断密切相关(aOR 2.421[1.197, 4.898])。与非 PUD 组相比,PUD 患者出现胰腺功能不全的可能性较低(aOR 0.583 [0.455, 0.745]):尽管囊性纤维化历来被认为是一种儿童疾病,但治疗的进步延长了患者的预期寿命,并提高了囊性纤维化相关消化系统疾病的患病率。这项研究显示,囊性纤维化患者中 PUD 的发病率较低。西班牙裔和患有 NASH 的人更容易患消化性溃疡。
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Low prevalence of peptic ulcer disease in hospitalized patients with cystic fibrosis: A national database study.

Background: Although cystic fibrosis (CF) is widely considered a lung disease, the prevalence of CF-specific gastrointestinal symptoms and diseases has continued to rise. Peptic ulcer disease (PUD) has not been well-studied among people with CF (PwCF) and may be a common cause of abdominal symptoms. In PwCF, impaired bicarbonate secretion and unbuffered gastric acid production have been attributed to the development of ulcers, although ulcers remain uncommon. The objective of this study was to evaluate the prevalence of PUD in PwCF and assess for possible contributing factors.

Methods: This study utilized the National Inpatient Sample (NIS) database. All patients 18 years or older with CF were identified from 2014 to 2019. Relevant patient characteristics and procedures were identified using ICD-9 and ICD-10 codes. Linear trend, bivariate analyses, and multiple regression analysis were performed. The outcomes of interest were peptic ulcer disease, pancreatic insufficiency, and nonalcoholic steatohepatitis or NASH. All analyses accounted for complex sampling scheme of the NIS.

Results: The total prevalence of PwCF in the National Inpatient Sample (NIS) database was 0.08 %, and the number was stable year to year from 2014 to 2019. Hispanic patients were more likely to be diagnosed with PUD than other white (aOR 1.802 [1.311,2.476]). Multiple regression analysis indicated that PUD in PwCF was strongly associated with a diagnosis of NASH (aOR 2.421[1.197, 4.898]). PUD patients were less likely to have pancreatic insufficiency compared to the non-PUD group (aOR 0.583 [0.455, 0.745]).

Conclusion: Although cystic fibrosis has been historically known as a disease of childhood, advancements in therapy have led to prolonged life expectancy and higher prevalence for cystic fibrosis-related digestive diseases. This study revealed a low prevalence of PUD in PwCF. Hispanics and those with NASH are more likely to develop peptic ulcers.

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