JGH: 克罗恩病简单内镜评分(CD-SES)对克罗恩病术后结果预测作用

2021-10-13 MedSci原创 MedSci原创

克罗恩病 (CD) 患者的肠道存在慢性透壁炎症,因此导致经常需要手术进行肠狭窄或瘘管的治疗。

       克罗恩病 (CD) 患者的肠道存在慢性透壁炎症,因此导致经常需要手术进行肠狭窄或瘘管的治疗。鉴于多达70%的CD患者肠切除术后1年内会出现内镜复发,因此,术后内镜监测对于预防复发很重要。Rutgeerts等人评估了回结肠后新末端回肠 (neo-TI) 的疾病活动性后发现使用评分系统证明术后出现早期炎症的新TI是 CD 临床复发的危险因素。虽然 Rutgeerts 评分 (RS) 适用于评估具有回结肠吻合术的回肠或回结肠 CD 患者的术后结果,但RS不能用于评估术后结肠疾病。同时,CD 的简单内窥镜评分 (SES-CD) 是 CD 内窥镜检查的简化评分,可以用来评估结肠和回肠每个部分的溃疡大小、溃疡和受影响的表面以及狭窄以确定疾病活动性。因此,本研究旨在根据疾病位置评估术后结果,并验证 CD 的简单内窥镜评分 (SES-CD) 以预测疾病的能力。

 

       研究人员回顾性分析了 2005 年至 2016 年在芝加哥大学进行手术的术后12个月内接受回肠结肠镜检查 CD患者的医疗记录,其中无结肠受累为主要疾病形式。主要观察结局包括临床和手术复发。

 

      在 207 名 CD 患者中,分别有 51 名 (24.6%) 和 156 名 (75.4%) 患者患有结肠主导疾病和 小肠(SI)主导疾病。与以SI为主的疾病患者相比,以结肠为主的疾病患者术后临床复发的风险更大(P = 0.018)。尽管无复发生存率没有显着差异,但与SI主导疾病相比,结肠主导疾病是早期手术复发的风险。此外,SES-CD 为 1 是预测 SI 主导疾病临床复发的最合适的截止值,但结肠主导疾病需要更高的 SES-CD的分数(截止值=5)。

 

      本项研究证明了 SES-CD 可预测 CD 的术后临床复发,并且无论疾病位置如何,其效能均比较满意。

 

 

原始出处:

Shintaro Akiyama. Et al. Predictability of simple endoscopic score for Crohn's disease for postoperative outcomes in Crohn's disease. Journal of Gastroenterology and Hepatology.2021.

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  2. [GetPortalCommentsPageByObjectIdResponse(id=1262258, encodeId=35f1126225884, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, 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=Fri Oct 15 12:40:54 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569788, encodeId=e4601569e8898, content=<a href='/topic/show?id=49e0161680c' target=_blank style='color:#2F92EE;'>#SES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16168, encryptionId=49e0161680c, topicName=SES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6fc215562628, createdName=dongjia2015, createdTime=Fri Oct 15 12:40:54 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060616, encodeId=231d1060616c9, content=评分需经过时间检验, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ece61961273, createdName=雲深無迹, createdTime=Fri Oct 15 07:36:11 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060430, encodeId=a44d1060430c4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Thu Oct 14 12:49:34 CST 2021, time=2021-10-14, status=1, ipAttribution=)]
    2021-10-15 dongjia2015
  3. [GetPortalCommentsPageByObjectIdResponse(id=1262258, encodeId=35f1126225884, content=<a href='/topic/show?id=0ceb30545e0' target=_blank style='color:#2F92EE;'>#内镜#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=42, 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=Fri Oct 15 12:40:54 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1569788, encodeId=e4601569e8898, content=<a href='/topic/show?id=49e0161680c' target=_blank style='color:#2F92EE;'>#SES#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16168, encryptionId=49e0161680c, topicName=SES)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6fc215562628, createdName=dongjia2015, createdTime=Fri Oct 15 12:40:54 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060616, encodeId=231d1060616c9, content=评分需经过时间检验, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ece61961273, createdName=雲深無迹, createdTime=Fri Oct 15 07:36:11 CST 2021, time=2021-10-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1060430, encodeId=a44d1060430c4, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=a0a85549889, createdName=ms2000000182667314, createdTime=Thu Oct 14 12:49:34 CST 2021, time=2021-10-14, status=1, ipAttribution=)]
    2021-10-15 雲深無迹

    评分需经过时间检验

    0

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    2021-10-14 ms2000000182667314

    学习了

    0

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