与急性严重性结肠炎救援疗法的反应相关的因素
Christopher F D Li Wai Suen1,2, Dean Seah1, Matthew C Choy1,2
1Department of Gastroenterology, Austin Health, Melbourne, VIC, Australia.
Inflammatory bowel diseases
|September 19, 2023
概括
在急性严重性结肠炎 (ASUC) 中预测救援治疗的反应至关重要. 诸如老年,感染,高C反应蛋白 (CRP) 和严重的内镜发现等因素表明,对ASUC救援疗法的不反应风险更高.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 急性严重性结肠炎 (ASUC) 是一种严重的疾病,如果救援疗法失败,就需要进行大肠切除.
- 预测对初始皮质类固醇治疗的反应已经得到了充分的研究,但影响救援治疗结果的因素需要进一步研究.
- 了解救援治疗反应的预测因素对于改善ASUC患者的临床结果至关重要.
研究的目的:
- 审查现有证据,以评估ASUC的成年人与救援疗法的反应相关的因素.
- 确定救援疗法的成功或失败的临床,血液学,生物化学,内镜和药理学预测因素.
- 突出未来研究领域,以加强ASUC的预测和预后模型.
主要方法:
- 进行了系统的文献搜索,以确定相关研究.
- 两个独立审查员评估了检索到的记录的资格.
- 最终分析包括了101项研究,涵盖了各种预测因素.
主要成果:
- 确定了与救援治疗反应相关的42个因素.
- 年龄较大 (≥50岁),先前使用氨酸和感染 (CMV,C. difficile) 预测反应较差.
- 生物化学标志物 (高CRP,低白蛋白) 和严重的内镜评分 (Mayo 3,UC-ESI ≥5) 与更糟糕的结果有关.
结论:
- 特定因素可以预测ASUC中救援治疗的反应,帮助临床决策.
- 将已知的和新的因素整合到预测模型中可以改善患者的治疗结果.
- 需要进一步的研究来确定便calprotectin和infliximab药物水平在ASUC管理中的作用.
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