Gastroenterology:克罗恩病患者获得1年的深度缓解可延缓疾病进展

2020-04-11 MedSci原创 MedSci原创

本项研究旨在探究早期克罗恩病(CD)患者经过诱导深层缓解后疾病的进展情况

背景与目标:本项研究旨在探究早期克罗恩病(CD)患者经过诱导深层缓解后疾病的进展情况。

方法:研究人员收集了122例中度至重度CD(中位持续时间为0.2年)的患者的随访数据(平均年龄31.2±11.3年),50%的患者(n = 61)被随机分配到严格控制策略(根据粪便中钙卫蛋白的粪便水平,C反应蛋白的血清水平和症状而增加治疗),而50%的患者被分配为常规治疗组。研究人员根据指标(CD内窥镜下严重性评分低于4,未进行深溃疡或类固醇治疗,持续8周或更长时间)将患者分类为在随访期末未达到深度缓解的患者或没有。主要观察结局是主要不良结局,这些结局表明随访期间CD进展:新的内瘘或脓肿,狭窄,肛周瘘或脓肿或CD住院或手术。

结果:本项研究随访期间报告了34例患者的严重不良后果(27.9%)。在研究结束时,深部缓解的患者在随访期间出现严重不良预后的情况明显减少(P = .01)。当对潜在的混杂因素进行调整时,深度缓解(调整后的危险比为0.19; 95%CI为0.07-0.31)与较低的重大不良后果风险显着相关。

结论:本项研究表明早期,中度至重度CD的深层缓解的诱导与3年中位数时间内疾病进展风险的降低相关联。

原始出处:

Ryan C. Ungaro. Et al. Deep Remission at 1 Year Prevents Progression of Early Crohn’s Disease. Gastroenterology.2020.

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    2020-07-19 许安
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