炎症性肠病患者延续性护理教育的研究进展

炎症性肠病(inflammatory bowel disease, IBD)延续性护理教育对于减少患者就诊次数、降低医疗费用、缓解患者心理压力、提升患者生活质量方面均具有积极意义.本文就IBD患者延续性护理教育形式及内容进行综述.     

炎症性肠病肠外表现的临床特点及治疗进展

炎症性肠病(inflammatory bowel disease,IBD)是一种慢性、复发性、免疫性胃肠道炎症.IBD主要包括:克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC).IBD可出现多种肠外表现,涉及消化系统、泌尿生殖系统、肌肉骨骼、肺、心脏、眼部、皮...     

硫唑嘌呤治疗炎症性肠病诱发淋巴瘤

炎症性肠病(inflammatory bowel disease,IBD)是一类肠道免疫系统过度激活引起的慢性非特异性炎症性疾病,包括溃疡性结肠炎(ulcerative colitis,UC)与克罗恩病(Crohn’s disease,CD).免疫抑制剂在IBD患者中广泛应用,且对于IBD治疗有效,但是这些药物诱发淋巴瘤的发生报道越来越多,尤其以硫唑嘌呤(azathioprine,AZA)为甚.AZA治疗IBD是否使淋巴瘤风险增加引起越来越多的关注.本文主要对于AZA在IBD临床应用、诱发淋巴瘤发生的可能机制、风险评估等进行讲述.     

营养与炎症性肠病

炎症性肠病(inflammatory bowel disease,IBD)包括克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC),发病与肠黏膜免疫调节紊乱、持续的肠道感染、肠黏膜屏障缺损、遗传和环境等多重因素相关.营养问题在IBD中的多方面作用目前受到越来越多的重视,包括营养在疾病的发生、病程中并发营养缺陷、营养在疾病中的治疗等.本文主要对营养与IBD的关系作一初步综述.     

炎症性肠病的肠内营养治疗

正炎症性肠病(inflammatory bowel disease,IBD)是一种免疫介导的慢性复发性肠道炎症疾病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD)。营养不良是IBD常见的肠外表现之一,是炎症性肠病预后不良的一个重要因素。营养不良与IBD的预后、并发症发生率、死亡率、生活质量及医疗负担等密切相关,营养支持治疗对IBD的疗效已被认可,IBD患者应该记录营养不良并     

炎症性肠病肠道淋巴细胞归巢研究进展

炎症性肠病(inflammatory bowel disease,IBD)是慢性肠道炎症疾病,传统上分为溃疡性结肠炎(ulcerative colitis,uc)和克罗恩病(Crohn's disease,CD).诸多研究表明,IBD与肠道淋巴细胞归巢(lymphocyte homing,LH)密切相关,本文就IBD与LH研究进展作一综述.     

极早发型与儿童及青少年炎症性肠病治疗策略

炎症性肠病(inflammatory bowel disease,IBD) 可见于各年龄段,若患者发病年龄小于6 岁,可称为极早发型炎 症性肠病(very early-onset inflammatory bowel disease,VEO-IBD)。VEO-IBD 多由单基因突变所致,与儿童及青少 年IBD 发病机制不同;两者临床表现与疾病自然病程亦有不同,VEO-IBD 发病时症状重,以炎症反应为主,多表现 为广泛性结肠病变,伴发严重全身表现,具有较高的病死率;两者治疗策略亦存在不同。文章总结了VEO-IBD 与 儿童及青少年IBD 的治疗进展,阐述了两者治疗策略选取的不同。     

炎症性肠病的肠外表现

炎症性肠病（inflammatory bowel disease，IBD），包括溃疡性结肠炎（ulcerative colitis，UC）和克罗恩病（Crohn’s disease，CD），其肠外表现众多，可累及全身各器官。国内对IBD肠外表现的大规模统计资料较少。本研究对136例IBD患者进行回顾性分析，调查其肠外表现的发生情况。     

T淋巴细胞亚群在炎症性肠病中作用的研究

炎症性肠病(inflammatory bowel disease,IBD)主要包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD),是一种反复发作的慢性炎症性肠道疾病,通常认为IBD的发生、发展与自身免疫系统异常关系密切.胃肠道需要在耐受内容物及对病原体的免疫...     

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炎症性肠病(inflammatory bowel disease,IBD)是一种慢性非特异性肠道炎症性疾病,主要包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD).其发病机制十分复杂,尚未完全阐明.     

Translation and validation of the Chinese Social Role Participation Questionnaire in patients with ankylosing spondylitis

Social Role Participation Questionnaire (SRPQ) is used to evaluate the social participation with ankylosing spondylitis (AS). Although the SRPQ has English and Dutch versions, there is no Chinese version even though China has the largest population of patients with AS. The objective of our study was to translate the SRPQ into Chinese version and assess its reliability and validity in Chinese patients with AS. The C-SRPQ was developed in a five-step translation and cross-cultural adaptation procedure. A total of 105 patients with AS were recruited during the time from September 2014 to June 2017. The intraclass correlation coefficient (ICC), Cronbach’s alpha (α), and Spearman correlation coefficient (r) were used to evaluate test-retest reliability, internal consistency reliability, and the construct validity of C-SRPQ, respectively. All of the 105 patients with AS successfully completed the questionnaires. Ninety-eight patients (93.33%) participated in at least nine roles for satisfaction dimensions. No floor or ceiling effects were checked. The high value of ICC (>?0.8, 0.831–0.895) indicated the excellent test-retest reliability. In internal consistency reliability, most of Cronbach’s alpha coefficient was strong (α?≥?0.7, 0.534–0.962). In construct validity, more than half of the correlations between the dimensions of C-SRPQ and other questionnaires were good (r?>?0.6). The correlations between all dimensions of C-SRPQ and BASDAI, BASFI, and ASQoL were strong negative (P?<?0.01). There was a strong positive correlation (P?<?0.01) between all dimensions of C-SRPQ and SF-36 physical component score (SF-36PCS), SF-36 mental component role score (SF-36MCS). The C-SRPQ is a reliable and valid questionnaire to evaluate the social participation in Chinese patients with AS.     

慢性阻塞性肺疾病评估测试对生存质量的评估价值研究

目的探讨慢性阻塞性肺疾病(COPD)评估测试(CAT)用于我国COPD患者生存质量的应用价值。方法选择2010年4月至2011年2月中国医科大学附属第一医院呼吸内科就诊和定期随访的COPD患者107例,其中男57例,女50例,年龄40～86岁,平均(67.4±9.8)岁。分别对患者进行中文版CAT和圣.乔治呼吸问卷(SGRQ)调查,同时进行肺功能测定。验证CAT的信度及效度,采用Spearman秩相关分析CAT评分与SGRQ评分、CAT评分与肺功能指标之间的相关性。结果 CAT的克龙巴赫α系数为0.796;CAT每个问题单项分值与总分值的Spearman秩相关系数为0.413～0.758(P<0.01);通过因子分析,最终抽取2个维度,可以解释总体方差的59.18%,各维度与量表总体的相关系数(0.960,0.549,P<0.01)大于维度间的相关系数(0.292)(P<0.01)。CAT总评分与SGRQ总评分呈显著正相关(r=0.735,P<0.01),第一秒用力呼气容积占预计值百分比(FEV1%)呈显著负相关(r=-0.441,P<0.01),与FEV1占用力肺活量(FVC)百分比(FEV1/FVC)亦呈显著负相关(r=-0.324,P<0.01)。结论中文版CAT是一种简易、可靠、有效的新型COPD患者生存质量评估问卷,可以很好地反映中国COPD患者的生存质量,适用于中国COPD患者的生存质量的评估。     

Assessment of disease specific knowledge and health-related quality of life among United States military veterans with inflammatory bowel disease

AIM: To evaluate the association between patient disease knowledge of inflammatory bowel disease(IBD)and health related quality of life(HRQoL) and identify patient and disease related predictors of patient knowledge of IBD.METHODS: We performed a cross-sectional study of IBD patients with an established diagnosis of IBD longer than 3 mo prior to enrollment. The Crohn's and colitis knowledge score(CCKNOW) and short inflammatory bowel disease questionnaire(SIBDQ) were selfadministered to assess patient knowledge of IBD and HRQoL, respectively. Demographic and disease characteristics were abstracted from the electronic medical record. The correlation between CCKNOW and SIBDQ scores was assessed by a linear regression model. Associations of patient knowledge and the variables of interest were calculated using ANOVA.RESULTS: A total of 101 patients were recruited.Caucasian race, younger age at diagnosis, and havinga college or post-graduate degree were significantly associated with higher CCKNOW scores. Patients with CD had higher CCKNOW scores compared to patients with ulcerative colitis and inflammatory bowel disease type unclassified, P 0.01. There was no significant correlation between overall CCKNOW and SIBDQ scores(r 2 = 0.34, P = 0.13). The knowledge sub-domain of diet in CCKNOW was negatively correlated with HRQoL(r 2 = 0.69, P 0.01).CONCLUSION: IBD diagnosis at a younger age in addition to Caucasian race and higher education were significantly associated with higher knowledge about IBD. However, patient knowledge of IBD was not correlated with HRQoL. Further studies are required to study the effect of patient knowledge of IBD on other clinical outcomes.     

匹兹堡睡眠质量指数在肠易激综合征患者中的应用评价

背景：肠易激综合征（IBS）患者常伴明显的睡眠障碍,但目前临床上尚缺乏专用于IBS患者的睡眠质量评价量表。目的：分析匹兹堡睡眠质量指数（PSOI）评价IBS患者睡眠质量的信度、效度和反应度。方法：纳入符合罗马Ⅲ标准的成人IBS患者201例,受试者自行完成PSQI。随机抽取42例患者于2周后重测。结果：IBS患者的总失眠率为25．9％,PSQL总均分为5．83±2．89．重测信度K值为0．810,分半信度系数为0．787,总体Cronbach’s α系数为0．789。效度分析示主成分累计方差贡献率为67．5％。项目分析法示PSQI具有鉴别出不同受试者的反应度。结论：PSQI具有良好的信度、效度和反应度．可用于IBS患者睡眠质量的综合评价．     

Quality of care for patients with inflammatory bowel disease in East China

AIM： To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease （IBD） from East China according to the current practice guidelines, METHODS： A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents （such as azathioprine） at admission and outpatient clinic visit were analyzed. RESULTS： A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn＇s disease （CD） and 106 with ulcerative colitis （UC）. All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 （39.7%） patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only （52.8% vs 25.0%, P = 0.019）. Thirty-one （54.4%） patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 （19.6%） received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION： The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therap     

Current use of immunosuppressive agents in inflammatory bowel disease patients in East China

AIM： To investigate immunosuppressive agents used to treat inflammatory bowel disease （IBD） in East China.
METHODS： A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University from June 2000 to December 2007, Data regarding demographic, clinical characteristics and immunosuppressants usage were analyzed,
RESULTS： A total of 227 eligible patients were evaluated in this study, including 104 patients with Crohn＇s disease and 123 with ulcerative colitis. Among the patients, 61 had indications for immunosuppressive agents use. However, only 21 （34.4%） received immunosuppressive agents. Among the 21 patients, 6 （37.5%） received a subtherapeutic dose of azathioprine with no attempt to increase the dosage. Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo, 15 patients went into remission, four patients were not affected and one relapsed. Among these 20 patients, four patients suffered from myelotoxicity and one suffered from hepatotoxicity.
CONCLUSION： Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries. Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.     

Evaluation of the Inflammatory Bowel Disease Questionnaire in Swedish patients with Crohn's disease

Objective. Health-related quality of life (HRQoL) is an important measure of inflammatory bowel disease (IBD) health outcome. The Inflammatory Bowel Disease Questionnaire (IBDQ) comprising 32 items grouped into four dimensions is a widely used IBD-specific HRQoL instrument. The purpose of this study was to evaluate the validity, reliability and responsiveness of the Swedish translation of the IBDQ in patients with Crohn's disease (CD). Material and methods. Four hundred and forty-eight patients with CD completed the IBDQ and three other HRQoL questionnaires (Rating Form of IBD Patient Concerns; Short Form-36; and the Psychological General Well-Being Index) in connection with their regular visit at the outpatient clinic. Disease activity was assessed by the physician on a 4-point Likert scale. Thirty-two patients who were stable in remission completed the questionnaires a second time, 4 weeks later. A total of 418 patients repeated all measurements after 6 months. Results. The dimensional scores were highly correlated with other measures of corresponding aspects of HRQoL and were significantly better in remission than in relapse. High test–retest correlations indicated good reliability. Responsiveness was confirmed in patients whose disease activity changed over time. However, high correlations between the dimensions, poor correlations between items within each dimension, and factor analysis all indicated that the original grouping of the items is not valid for Swedish CD patients. Conclusions. Although the Swedish IBDQ has good external validity, reliability and responsiveness for patients with CD, our results did not support the original grouping of the items.     

疾病家庭负担量表应用于晚期血吸虫病的信度和效度

目的 评价疾病家庭负担量表(family burden scale of diseases,FBS)应用于晚期血吸虫病(晚血)的信度和效度,为晚血家庭负担评价工具的选择提供科学依据.方法 在湖南省汉寿县及湖北省江陵县,以FBS作为测评工具对晚血患者家属进行入户调查,评价其应用于晚血的信度和效度.结果共调查家属318名,...     

中国精神疾病预测量表的研制及其信效度检验

目的编制中国精神疾病预测量表并进行信度、效度检验。方法通过预测验构建初问卷,并采用探索性因素分析、验证性因素分析、相关分析等方法分析数据,检验其信效度。结果根据因子分析结果,提取11个因子,另含一个掩饰因子,正式量表含有96个条目,累计方差贡献率为55.23%。总量表的Cronbach'sα系数为0.844,各个因子的Cronbach'sα系数为0.640~0.788;总量表的分半系数为0.892,各个因子的分半系数为0.617~0.742(均P0.01)。验证性因素分析模型拟合优度指数显示:CMIN=3 915.815,DF=957,CMIN/DF=4.092,GFI=0.920,TLI=0.878,IFI=0.930,CFI=0.847,RMSEA=0.058。总量表的重测相关系数为0.803,各个因子重测相关系数为0.601~0.737(均P0.01)。中国精神疾病预测量表各个因子之间存在显著相关,相关系数为0.512~0.948(均P0.01),总分及各因子存在显著相关,相关系数为0.673~0.961(均P0.01)。除神经症和应激源因子外,中国精神疾病预测量表与中国军人心理健康量表各因子分呈显著正相关,相关系数为0.362~0.618(P0.05或P0.01)。结论中国精神疾病预测量表的信度、效度符合心理测量学要求,可作为中国人精神疾病预测的评估工具。