JCC: 克罗恩病长期内镜治疗的效果与粪钙卫蛋白水平相关

2021-03-07 MedSci原创 MedSci原创

克罗恩病(CD)是胃肠道的炎症性疾病,其特征在于缓解期和复发期的交替出现。患者可以以多种表现形式发病,例如腹痛,腹泻,肠梗阻或肛周瘘管等,但有些可能是无症状的。

      克罗恩病(CD)是胃肠道的炎症性疾病,其特征在于缓解期和复发期的交替出现。患者可以以多种表现形式发病,例如腹痛,腹泻,肠梗阻或肛周瘘管等,但有些可能是无症状的。历史上,CD的治疗一直集中在症状改善上。最近,内窥镜愈合已成为治疗的目标,因为内窥镜愈合的实现与长期疗效的改善相关,例如降低未来复发风险,住院治疗和手术切除的需要。但是,反复进行结肠镜检查以评估内镜愈合情况可能无法为患者所接受。结果,人们越来越关注使用与内窥镜检查密切相关的生物标志物,其中粪便钙卫蛋白是中性粒细胞的胞质成分,并随着中性粒细胞的活化和降解而释放。据报道钙卫蛋白的浓度与CD的内窥镜活性之间存在相关性。因此,这项研究的目的是评估粪便钙卫蛋白对短期和长期临床及内镜结果的预测性能。

 

 

 

      本项研究共包括了677名患者,通过使用ROC曲线并比较区域面积来评估第6周钙卫蛋白截止值与钙卫蛋白基线评估的变化之间的关系。使用针对混杂因素调整的多元逻辑回归模型评估第6周的临床和生物标志物评估与第52周的内镜缓解[ER]之间的关系。

 

 

 

      研究发现:第6周粪钙卫蛋白小于250 mg/kg的显示出显着的准确预测第52周ER的能力(AUC 0.709,95%[CI] 0.566–0.852,p = 0.014),并且比其他粪钙卫蛋白截止值表现更好预测能力。校正协变量后,第6周粪便钙卫蛋白<250 mg/kg的患者发生 52周ER的几率增加了3.48倍[95%CI 1.31–9.28,p = 0.013]。

 

 

 

      总之,通过本项研究表明第6周CD患者粪钙卫蛋白水平<250 mg / kg可以预测未来长期的内镜下粘膜愈合,并且可能比临床症状的改善更为有益。

 

 

 

原始出处:

Neeraj Narula. Et al. Week 6 Calprotectin Best Predicts Likelihood of Long-term Endoscopic Healing in Crohn’s Disease: A Post-hoc Analysis of the UNITI/IM-UNITI Trials. Journal of Crohn's and Colitis. 2021.

 

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  1. [GetPortalCommentsPageByObjectIdResponse(id=946906, encodeId=edc29469068b, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习到很多东西, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/b75ef807ee37426488262434e88f2054/ddba9eab8dcf4ab582aa531cff52c0a8.jpg, createdBy=f7cf2444395, createdName=小希言, createdTime=Tue Mar 09 21:02:48 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262232, encodeId=0f971262232c5, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440695, encodeId=8cfb144069598, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047298, encodeId=02c4104e298fd, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 20:01:37 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946210, encodeId=2cd194621093, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Mar 07 17:43:08 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-03-09 小希言

    #学习#学习到很多东西

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=946906, encodeId=edc29469068b, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习到很多东西, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/b75ef807ee37426488262434e88f2054/ddba9eab8dcf4ab582aa531cff52c0a8.jpg, createdBy=f7cf2444395, createdName=小希言, createdTime=Tue Mar 09 21:02:48 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262232, encodeId=0f971262232c5, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440695, encodeId=8cfb144069598, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047298, encodeId=02c4104e298fd, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 20:01:37 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946210, encodeId=2cd194621093, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Mar 07 17:43:08 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=946906, encodeId=edc29469068b, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习到很多东西, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/b75ef807ee37426488262434e88f2054/ddba9eab8dcf4ab582aa531cff52c0a8.jpg, createdBy=f7cf2444395, createdName=小希言, createdTime=Tue Mar 09 21:02:48 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262232, encodeId=0f971262232c5, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440695, encodeId=8cfb144069598, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047298, encodeId=02c4104e298fd, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 20:01:37 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946210, encodeId=2cd194621093, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Mar 07 17:43:08 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
  4. [GetPortalCommentsPageByObjectIdResponse(id=946906, encodeId=edc29469068b, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习到很多东西, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/b75ef807ee37426488262434e88f2054/ddba9eab8dcf4ab582aa531cff52c0a8.jpg, createdBy=f7cf2444395, createdName=小希言, createdTime=Tue Mar 09 21:02:48 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262232, encodeId=0f971262232c5, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440695, encodeId=8cfb144069598, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047298, encodeId=02c4104e298fd, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 20:01:37 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946210, encodeId=2cd194621093, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Mar 07 17:43:08 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-03-07 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=946906, encodeId=edc29469068b, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学习到很多东西, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210307/b75ef807ee37426488262434e88f2054/ddba9eab8dcf4ab582aa531cff52c0a8.jpg, createdBy=f7cf2444395, createdName=小希言, createdTime=Tue Mar 09 21:02:48 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1262232, encodeId=0f971262232c5, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30545, encryptionId=0ceb30545e0, topicName=内镜)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1440695, encodeId=8cfb144069598, content=<a href='/topic/show?id=4f7a30582c3' target=_blank style='color:#2F92EE;'>#内镜治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30582, encryptionId=4f7a30582c3, topicName=内镜治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d9014754625, createdName=644982816_68283322, createdTime=Tue Mar 09 08:01:37 CST 2021, time=2021-03-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1047298, encodeId=02c4104e298fd, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sun Mar 07 20:01:37 CST 2021, time=2021-03-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=946210, encodeId=2cd194621093, content=好文章!, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160806/IMG57A5698BDB0244113.jpg, createdBy=32a91358059, createdName=jyzxjiangqin, createdTime=Sun Mar 07 17:43:08 CST 2021, time=2021-03-07, status=1, ipAttribution=)]
    2021-03-07 jyzxjiangqin

    好文章!

    0

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