JCC:持续性内镜治疗下判断溃疡性结肠炎患者复发的风险因素

2020-09-16 MedSci原创 MedSci原创

背景

背景

溃疡性结肠炎(UC)患者的深度缓解依赖于生化,内镜和/或组织学缓解的实现。在临床工作中,研究人员都会在内镜检查中评估了溃疡性结肠炎的症状缓解和内镜愈合(EH,梅奥内镜评分[MES] 0或1)程度,并把评估这样的指标作为治疗的终点。本项研究也就是从这个角度出发,探究内镜治疗下溃疡性结肠炎复发的危险因素。

 

 

方法

研究人员在一项回顾性队列中收集了一组达到内镜愈合(EH),和没有持续的组织学缓解和EH深度的持续性愈合的溃疡性结肠患者,并探究达到并达到症状缓解和未达到内镜下缓解的UC成年人的临床复发风险因素。并试图探讨了逐步降低的持续性EH患者复发的风险的措施。

 

 

结果

在最初达到EH的270例患者中,有89例在随访内窥镜检查下保持了症状缓解和EH的长期维持。在进行19个月的随访后,持续性EH患者的1年累积复发风险为11.5%,而持续性组织学缓解为9.5%。与继续进行指数治疗的患者相比,接受降级治疗的17例持续性EH患者的复发风险没有增加(5.3%vs 14%,p = 0.16)。

 

 

结论

在连续内镜检查中达到并维持症状缓解和EH 且达到目标临床缓解的活动性UC治疗且复发的风险较低,特别是在同时达到组织学缓解的部分患者中复发风险更低。

 

 

原始出处:

Sushrut Jangi. Et al. Risk of Relapse in Patients with Ulcerative Colitis with Persistent Endoscopic Healing: A Durable Treatment Endpoint. Journal of Crohn's and Colitis.2020.

 

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    2020-11-09 nymo
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