Gastroenterology Report: 通过磁共振成像评估英夫利昔单抗对肛周瘘管克罗恩病的疗效

2019-05-24 不详 MedSci原创

亚洲人群中,关于抗肿瘤坏死因子治疗肛周瘘管克罗恩病(PFCD)的影像学评估文献很少,因此,本项研究旨在评估英夫利昔单抗(IFX)对PFCD的有效性,并根据临床和放射学评估探索了“深度缓解”的预测因子。

背景和目标
亚洲人群中,关于抗肿瘤坏死因子治疗肛周瘘管克罗恩病(PFCD)的影像学评估文献很少,因此,本项研究旨在评估英夫利昔单抗(IFX)对PFCD的有效性,并根据临床和放射学评估探索了“深度缓解”的预测因子。

方法
研究人员将患有克罗恩病和活动性肛瘘的患者纳入了本项研究。每位患者根据瘘管引流评估指数,内镜检查评估克罗恩病活动指数(CDAI)和肛周克罗恩病活动指数(PCDAI),磁共振成像(MRI)确定Van Assche评分和Ng评分进行临床评估,在第六次IFX治疗(第32周)开始前2周进行实验室指标检查。

结果
在使用IFX治疗的38名患者中,52.6%基于瘘管引流评估指数达到临床缓解,42.1%基于Ng评分实现深度缓解。在六次IFX处理后,Van Assche评分(从14.5±4.26减少至7.36±7.53),CDAI(从170±92减少至71±69)和PCDAI(从7.45±2.65减少至2.44±3.20)显着下降。深度缓解的唯一预测因素是单纯性瘘管(P=0.004,HR= 3.802,95%置信区间:1.541-9.383)。

结论
IFX在中国PFCD患者中具有明显的疗效。MRI是评估PFCD的金标准。


原始出处:

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    2020-02-27 许安
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  6. [GetPortalCommentsPageByObjectIdResponse(id=2064723, encodeId=ea9a2064e23f4, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Dec 20 22:20:00 CST 2019, time=2019-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952770, encodeId=81b01952e70ed, content=<a href='/topic/show?id=d526811269f' target=_blank style='color:#2F92EE;'>#肛周瘘管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81126, encryptionId=d526811269f, topicName=肛周瘘管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Feb 23 10:20:00 CST 2020, time=2020-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711956, encodeId=cf571e1195685, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 14 00:20:00 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072572, encodeId=51c720e2572ea, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Feb 27 01:20:00 CST 2020, time=2020-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1764725, encodeId=281f1e6472522, content=<a href='/topic/show?id=3cc18112590' target=_blank style='color:#2F92EE;'>#肛周瘘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81125, encryptionId=3cc18112590, topicName=肛周瘘)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c42f37776896, createdName=12498cf9m47(暂无昵称), createdTime=Wed Oct 09 15:20:00 CST 2019, time=2019-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341662, encodeId=e22013416622e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sun May 26 09:20:00 CST 2019, time=2019-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504681, encodeId=167315046819d, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sun May 26 09:20:00 CST 2019, time=2019-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032165, encodeId=0a93103216514, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Fri May 24 21:20:00 CST 2019, time=2019-05-24, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=2064723, encodeId=ea9a2064e23f4, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Fri Dec 20 22:20:00 CST 2019, time=2019-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1952770, encodeId=81b01952e70ed, content=<a href='/topic/show?id=d526811269f' target=_blank style='color:#2F92EE;'>#肛周瘘管#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81126, encryptionId=d526811269f, topicName=肛周瘘管)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e34303, createdName=wetgdt, createdTime=Sun Feb 23 10:20:00 CST 2020, time=2020-02-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1711956, encodeId=cf571e1195685, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=25, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 14 00:20:00 CST 2020, time=2020-04-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072572, encodeId=51c720e2572ea, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu Feb 27 01:20:00 CST 2020, time=2020-02-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1764725, encodeId=281f1e6472522, content=<a href='/topic/show?id=3cc18112590' target=_blank style='color:#2F92EE;'>#肛周瘘#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81125, encryptionId=3cc18112590, topicName=肛周瘘)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c42f37776896, createdName=12498cf9m47(暂无昵称), createdTime=Wed Oct 09 15:20:00 CST 2019, time=2019-10-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1341662, encodeId=e22013416622e, content=<a href='/topic/show?id=24b8e37529a' target=_blank style='color:#2F92EE;'>#磁共振#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73752, encryptionId=24b8e37529a, topicName=磁共振)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=24a22500182, createdName=1696533704_45270454, createdTime=Sun May 26 09:20:00 CST 2019, time=2019-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504681, encodeId=167315046819d, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=20, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Sun May 26 09:20:00 CST 2019, time=2019-05-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1032165, encodeId=0a93103216514, content=谢谢梅斯提供这么好的信息,学到很多, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=内科新手, createdTime=Fri May 24 21:20:00 CST 2019, time=2019-05-24, status=1, ipAttribution=)]
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    2019-05-24 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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存在肠腔狭窄的患者经常会行狭窄成形术来缓解梗阻情况,但是在狭窄部位的克罗恩病早期易于复发,因此,本项研究的目的是探究原发性狭窄成形术后早期再次手术复发的危险因素。

JCC: 静脉注射造影剂在克罗恩病活动超声评估中的作用

据报道,对比增强超声[CEUS]在使用内窥镜检查作为参考标准预测疾病活动方面优于彩色多普勒成像[CDI]。本项研究的目的是确定患有克罗恩病[CD]的患者,在CEUS检查之前进行CDI检查是否有助于确定何时注射造影剂而不减少CEUS的诊断效能。

JCC: 腔内对比增强超声可用来高效检测克罗恩病脓肿相关的穿透性病变

穿透性病变是克罗恩病[CD]常见的并发症。确定瘘管的存在和位置对于确定适当的治疗策略是至关重要的。本项研究的目的是评估腔内对比增强超声[IC-CEUS]用于检测CD患者脓肿相关的瘘管准确性。

Digest Liver Dis: 克罗恩病患者肠道切除术后一年内预防性药物治疗的生活质量改善情况分析

接受肠切除术的克罗恩病(CD)患者术后接受预防性药物治疗后生活质量改善情况究竟是怎样的还没有文献进行研究,因此,本项研究旨在探究这其中的关系。

Dig Liver Dis: 影响IBD患者维生素D缺乏的因素分析

维生素D缺乏症在炎性肠病(IBD)中普遍存在,并且可能与疾病活动有关。因此,本研究评估了意大利IBD患者队列中的维生素D(VitD)状态,并调查了VitD缺乏的危险因素及其与疾病活动的相关性。

JCC: Ustekinumab治疗难治性克罗恩病的儿科患者的疗效分析

Ustekinumab [UST]可有效治疗中重度克罗恩病患者[CD]。关于其在儿童中使用的数据很少。因此,本项研究旨在评估中重度CD患儿对UST的反应。