J Gastroenterology: 磁共振成像评估肠壁愈合可预测克罗恩病的持续临床缓解和降低手术风险

2019-04-06 不详 MedSci原创

内镜下粘膜愈合被认为是克罗恩病(CD)的最佳治疗终点,因为它与更好的长期结果相关。本项研究旨在评估使用磁共振成像(MRI)是否可以评估的肠壁愈合(BWH)情况。

背景
内镜下粘膜愈合被认为是克罗恩病(CD)的最佳治疗终点,因为它与更好的长期结果相关。本项研究旨在评估使用磁共振成像(MRI)是否可以评估的肠壁愈合(BWH)情况。

方法
研究人员对两项前瞻性研究(n= 174名患者)进行了事后分析。完整BWH定义为无节段性MaRIA> 7或无节段性克莱蒙评分> 8.4且BWH为无节段性MaRIA> 11或无节段性克莱蒙评分> 12.5。临床无皮质类固醇缓解(CFREM)定义为临床表现无再现或恶化,导致治疗性改变,住院或CD相关手术。

结果
本项研究共分析了63名患有CD的患者的临床数据。在多变量分析中,根据MaRIA,完整的BWH与持续的CFREM相关[OR = 4.42(2.29-26.54); p= 0.042]或克莱蒙评分[OR = 3.09(1.01-12.91); p= 0.049]。在多变量分析中,完全BWH与使用MaRIA的手术风险降低相关[HR = 0.16(0.043-0.63); p= 0.008]

结论
MRI可以用来评估CD患者肠道粘膜的愈合情况且可预测药物治疗后效果。

原始出处:

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    2020-01-04 许安
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艰难梭菌感染(CDI)在炎症性肠病(IBD)患者中很常见,常常会导致诊断错误以及IBD治疗升级的延迟。本研究旨在评估接受逐步升级的免疫抑制治疗的IBD患者感染CDI后的预后结局。

J Gastroenterology:抗肿瘤坏死因子治疗降低了克罗恩病患者初次肠道手术的风险

抗肿瘤坏死因子(TNF-α)疗法可以诱导并维持克罗恩病(CD)患者的临床缓解。然而,抗TNF治疗对CD自然病程的影响仍存在争议。因此,本项研究的目的是研究抗TNF治疗对CD初始肠道手术的影响。