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首页> 美国卫生研究院文献>Canadian Journal of Gastroenterology >Characterization of inflammatory bowel disease in elderly patients: A review of epidemiology current practices and outcomes of current management strategies
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Characterization of inflammatory bowel disease in elderly patients: A review of epidemiology current practices and outcomes of current management strategies

机译：老年患者炎症性肠病的特征：流行病学当前做法和当前管理策略的成果的审查。

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The authors review and summarize the current literature regarding the epidemiology, clinical presentation and management of inflammatory bowel disease (IBD) in elderly patients.Among elderly patients, the incidence of ulcerative colitis (UC) is higher than that of Crohn disease (CD). Elderly patients with a new diagnosis of UC are more likely to be male and have left-sided colitis. Elderly patients with a new diagnosis of CD are more likely to be female and have colonic disease. Conversely, increasing age at diagnosis has been associated with a lower likelihood of having any of a family history of IBD, perianal disease in CD and extraintestinal manifestations. Although response to drug therapies appears to be similar in elderly patients and younger individuals, the elderly are more likely to receive 5-aminosalicylic acid agents, and less likely to receive immunomodulators and biologics. Corticosteroid use in the elderly is comparable with use in younger individuals. The rates of surgical intervention appear to be lower for elderly CD patients but not elderly UC patients. Elderly individuals with UC are more likely to need urgent colectomy, which is associated with an increased mortality rate. Elective surgery is associated with similar outcomes among the elderly and young patients with IBD. Therefore, the use of immunomodulators and biologics, and earlier consideration of elective surgery for medically refractory disease in elderly patients with IBD, should be emphasized and further evaluated to prevent complications of chronic corticosteroid(s) use and to prevent emergency surgery.
机译：作者回顾并总结了有关老年患者炎症性肠病（IBD）的流行病学，临床表现和治疗的最新文献。在老年患者中，溃疡性结肠炎（UC）的发生率高于克罗恩病（CD）。患有UC的新诊断的老年患者更有可能是男性，并且患有左侧结肠炎。患有CD新诊断的老年患者更有可能是女性，患有结肠疾病。相反，诊断时年龄的增加与患IBD家族史，CD的肛周疾病和肠外表现的可能性降低有关。尽管在老年患者和较年轻的人群中对药物疗法的反应似乎相似，但老年人更可能接受5-氨基水杨酸制剂，而接受免疫调节剂和生物制剂的可能性较小。老年人使用皮质类固醇可与年轻个体使用。老年CD患者的手术干预率似乎较低，但老年UC患者则不然。患有UC的老年人更可能需要紧急结肠切除术，这与死亡率增加相关。在老年和年轻的IBD患者中，择期手术的结果相似。因此，应该强调并进一步评估免疫调节剂和生物制剂的使用，以及较早考虑对IBD老年患者的难治性疾病进行择期手术，以预防慢性皮质类固醇使用的并发症并防止急诊手术。

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