Am J Gastroenterol:溃疡性结肠炎治疗后组织学缓解率

2019-05-29 MedSci MedSci原创

研究发现,目前UC治疗的组织学缓解率在15.0%-44.9%之间,以局部氨基水杨酸盐的治愈率最高

组织学缓解是评估溃疡性结肠炎(UC)疾病活动和治疗反应的一种潜在手段,然而,现有疗法对实现这一结果的效果还不清楚。研究人员对UC随机对照试验中的组织学结果进行了系统回顾和Meta分析,并检查了组织学和内镜结果之间的关系。

研究人员考察了Medline、EMBASE、Central和Cochrane IBD Register数据库中收录的氨基水杨酸盐、皮质类固醇、免疫抑制剂、生物制剂和小分子的随机对照试验,独立提取和汇集组织学、内镜缓解和治疗反应数据,采用单变量和多变量随机效应Meta回归模型检验组织学缓解相关因素。

本次研究收集了74项研究。局部氨基水杨酸灌肠(37.2%)和栓剂(44.9%)诱导组织学缓解率最高。氨基水杨酸灌肠(RR=4.14)、氨基水杨酸栓剂(RR=3.94)和布地奈德多(RR=1.47)的组织学缓解率高于安慰剂,缺乏生物制剂和免疫抑制剂的数据。诱导研究中,安慰剂组织学缓解率为10.4%。组织学和内窥镜病情缓解与此密切相关(r=0.66)。在安慰剂-臂数的多变量分析中,较轻的临床疾病活动和使用皮质类固醇与较高的组织学缓解率有关。同样,对活动臂数据进行分析时,轻微的临床疾病活动与较高的组织学缓解率有关。

研究发现,目前UC治疗的组织学缓解率在15.0%-44.9%之间,以局部氨基水杨酸盐的治愈率最高。

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    2020-04-30 许安
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    2019-08-01 nymo
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