Am J Gastroenterol:非活动期炎症性肠病患者的远程医疗

2019-04-22 MedSci MedSci原创

研究认为尽管所有参与者的疾病活动和生活质量都有所改善,但使用远程治疗系统与传统方案相比,未显现出明显优势。TELE-IBD受试者的住院率下降,非侵入性诊断测试、电话和电子产品使用率也相应增加

远程医疗是一种很有前景的炎症性肠病(IBD)治疗手段,近日研究人员比较了接受远程医疗和标准护理的IBD患者在1年随机试验中的疾病活动和生活质量(QoL)差异。

两年内未出现症状恶化的患者随机接受远程医疗 (每周【weekly】或隔周【EOW】短信提醒和远程监测) 或标准护理。研究的主要结果是各组间疾病活动和生活质量变化的差异;次要结果为组间医疗保健利用率的变化。

有348名参与者(对照组117名,EOW组 115名,weekly组116名),259人(74.4%)完成了研究。平均年龄38.9岁,女性56.6%,白种人91.9%,克罗恩病患者67.9%,基线时有活动性疾病患者42.5%。在CD中,所有组的疾病活动均下降(对照组-5.2±5.0至3.7±3.6,TELE-IBD EOW 4.7±4.1至4.2±3.9,TELE-IBD weekly 4.2±4.2至3.2±3.4),UC组只有对照组的疾病活动显著下降(对照组2.9±3.1至1.4±1.4, TELE-IBD EOW  2.7±3.1至1.7±1.9,TELE-IBD weekly 2.5±2.5至2.0±1.8)。所有组的QoL均增加,仅在远程IBD EOW组有显著增加(对照组168.1±34.0至179.3±28.2, TELE-IBD EOW 172.3±33.1至181.5±28.2,TELE-IBD weekly 172.3±34.5至179.2±32.8)。未调整和调整后的疾病活动和生活质量变化在各组间无显着性差异(P>0.05)。所有组的医疗保健利用率均有所提高。与对照组相比,TELE-IBD weekly组的IBD相关的住院治疗风险降低。与对照组相比,远程治疗组均减少了非IBD相关的住院治疗风险。

研究认为尽管所有参与者的疾病活动和生活质量都有所改善,但使用远程治疗系统与传统方案相比,未显现出明显优势。TELE-IBD受试者的住院率下降,非侵入性诊断测试、电话和电子产品使用率也相应增加。

原始出处:


本文系梅斯医学(MedSci)原创编译整理,转载需授权!

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1711921, encodeId=09f71e119212e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 23 23:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064699, encodeId=d4b920646990c, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Dec 25 15:00:00 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072541, encodeId=f6f120e25416e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu May 16 05:00:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547215, encodeId=c1bf154e21541, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600008, encodeId=89cc160000893, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1711921, encodeId=09f71e119212e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 23 23:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064699, encodeId=d4b920646990c, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Dec 25 15:00:00 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072541, encodeId=f6f120e25416e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu May 16 05:00:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547215, encodeId=c1bf154e21541, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600008, encodeId=89cc160000893, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1711921, encodeId=09f71e119212e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 23 23:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064699, encodeId=d4b920646990c, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Dec 25 15:00:00 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072541, encodeId=f6f120e25416e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu May 16 05:00:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547215, encodeId=c1bf154e21541, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600008, encodeId=89cc160000893, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
    2019-05-16 许安
  4. [GetPortalCommentsPageByObjectIdResponse(id=1711921, encodeId=09f71e119212e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 23 23:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064699, encodeId=d4b920646990c, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Dec 25 15:00:00 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072541, encodeId=f6f120e25416e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu May 16 05:00:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547215, encodeId=c1bf154e21541, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600008, encodeId=89cc160000893, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=1711921, encodeId=09f71e119212e, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Apr 23 23:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064699, encodeId=d4b920646990c, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Wed Dec 25 15:00:00 CST 2019, time=2019-12-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072541, encodeId=f6f120e25416e, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Thu May 16 05:00:00 CST 2019, time=2019-05-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547215, encodeId=c1bf154e21541, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1600008, encodeId=89cc160000893, content=<a href='/topic/show?id=508e6e03203' target=_blank style='color:#2F92EE;'>#炎症性肠病患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67032, encryptionId=508e6e03203, topicName=炎症性肠病患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a9fa18776644, createdName=huangshifeng, createdTime=Tue Apr 23 22:00:00 CST 2019, time=2019-04-23, status=1, ipAttribution=)]

相关资讯

AP&T:优化的英夫利昔单抗疗法与联合疗法在治疗炎症性肠病中同样有效

目前临床工作中会采用硫唑嘌呤联合英夫利西单抗治疗6-12个月的治疗方案,然而,在血药低谷水平主动剂量递增的优化英夫利昔单抗单药治疗是否是更安全的治疗方案还没有得到验证,因此,本项研究旨在比较联合治疗防范与优化单药治疗策略的效果。

IBD:淀粉的摄入会影响溃结患者储袋炎症及菌群改变

炎症性肠病(IBD)的特征在于对聚糖的血清学反应。溃疡性结肠炎(UC)患者在直肠吻合术后进行回肠 - 肛门吻合术(储袋手术)可能会出现类似克罗恩病(CD)的炎症。本项研究假设患者的血清学反应与饮食中糖有关。因此,本研究分析了UC小鼠患者抗糖链抗体表达与膳食糖消耗之间的相关性以及抗体水平随时间的变化。

Clin Gastroenterol H:硫嘌呤治疗的炎症性肠病患者发生鳞状细胞癌的死亡率分析

由此可见,尽管原因特异性死亡率相对较低,但暴露于硫嘌呤的IBD患者发生SCC后与仅暴露于5-ASA的患者相比,SCC相关死亡的风险增加。

IBD:Vedolizumab血清水平与炎症性肠病的临床缓解,生物标志物正常化和粘膜愈合有关

维多利珠单抗(VDZ)血清谷水平(VTL)在炎症性肠病(IBD)中的临床应用尚不明确。本研究的目的是确定维多珠单抗的中位数VTL水平和频率,以及VTL与C反应蛋白(CRP)和粘膜愈合(MH)的相关性。

AP&T: 老年IBD患者使用抗肿瘤坏死因子α和维多珠单抗药物效果一样出色

患有炎症性肠病(IBD)的老年患者群体特别容易受到疾病和治疗相关副作用的影响,因此,本项研究旨在比较肿瘤坏死因子α拮抗剂(抗TNFα)或维多珠单抗(VDZ)在年龄大于60岁IBD患者中的安全性和有效性。

JAHA:炎症和主动脉脉搏波速度

由此可见,长期抗TNFα治疗可降低IBD患者的aPWV,这是心血管风险已知的替代指标。这表明有效控制炎症可降低这些患者的心血管风险。