组织学愈合作为儿童性结肠炎持续临床缓解的预测因素
Luca Scarallo1, Lorenzo Fioretti2, Monica Paci2
1Gastroenterology and Nutrition Unit, Meyer Children Hospital IRCCS, Florence, Italy; Department of NEUROFARBA, University of Florence, Italy.
概括
在儿科性结肠炎 (UC) 患者中实现内镜治疗 (EH) 和组织学治疗 (HH) 可以减少疾病复发. 完全HH的患者经历了更长的无复发生存期,这表明了更好的长期结果.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 炎症性肠道疾病研究研究
- 在性结肠炎的临床结果.
背景情况:
- 儿童性结肠炎 (UC) 管理需要评估超出临床症状的愈合.
- 内镜愈合 (EH) 和组织愈合 (HH) 是儿科UC治疗成功的关键指标.
- 对儿科UC队列中EH和HH影响的纵向数据对于完善治疗策略至关重要.
研究的目的:
- 评估内镜治疗 (EH) 和组织学治疗 (HH) 与儿科性结肠炎 (UC) 患者的疾病复发之间的纵向关联.
- 为了确定实现不同水平的EH和HH是否会影响无复发生存率.
- 提供关于粘膜愈合在治疗儿科UC的预后价值的见解.
主要方法:
- 这是一项对86名儿科UC患者进行的回顾性,单中心纵向研究.
- 使用梅奥内镜分值 (MES) 进行内镜再评估,以确定部分 (MES=1) 和完整的EH (MES=0).
- 组织学评估将组织学愈合 (HH) 定义为没有活跃炎症;评估临床复发的累积发病率.
主要成果:
- 在重新评估时,68.6%的患者获得了EH (MES ≤1),其中66%的患者获得了完全的EH (MES=0).
- 在39名完全EH的患者中,有20名患者也获得了完全的HH.
- 获得部分或完全EH的患者表现出明显更高的无复发生存率 (p < 0.01). 完整的EH与HH的复发率低于不完整的EH (p=0.049).
结论:
- 内镜治疗 (EH) 和组织学治疗 (HH) 与小儿性结肠炎 (UC) 疾病复发的减少有显著的相关性.
- 实现完整的组织学愈合 (HH) 与内镜愈合相结合,导致更长的无复发生存期.
- 这些发现强调了包括粘膜愈合在内的深度缓解的重要性,以改善儿科UC的长期结果.
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