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最近使用类固醇和性结肠炎患者的复发风险与内镜愈合的患者
Tomohiro Fukuda1, Hajime Yamazaki2, Yusuke Miyatani3
1Department of Gastroenterology, Yokohama Municipal Citizen's Hospital, Kanagawa, Japan.
最近使用类固醇显著增加了性结肠炎 (UC) 患者的复发风险,这些患者已经实现了内镜治疗 (EH). 医生应考虑自最后一次使用类固醇以来的时间,以预测UC复发风险.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 炎症性肠道疾病研究研究
背景情况:
- 内镜治疗 (EH) 是性结肠炎 (UC) 的一个关键治疗目标.
- 然而,患有EH的患者经常经历频繁的复发.
- 预测UCE患者的复发风险对于有效管理至关重要.
研究的目的:
- 调查最近的全身类固醇使用与UC确诊EH患者复发风险之间的关联.
- 为了确定自上次使用类固醇以来的持续时间是否会影响该患者群体的复发率.
主要方法:
- 一项多中心队列研究,涉及1212名UC患者与EH (梅奥内镜子底值≤1).
- 患者被分为"最近使用类固醇组" (1年内最后一次使用) 和"非最近/未使用类固醇组".
- 一个2年的随访评估复发,定义为需要全身类固醇或先进疗法,使用后勤回归.
主要成果:
- 最近使用类固醇的患者的复发率 (28.8%) 与未使用类固醇或未使用类固醇的小组相比显著更高 (5.6%).
- 最近的类固醇组中复发的调整后几率比为5.53.
- 自从最后一次使用类固醇以来,复发风险随着时间的延长而逐渐降低,接近从未使用过类固醇的患者中观察到的比例.
结论:
- 最近的类固醇治疗与高复发风险有关,即使在已经实现内镜治疗的UC患者中,复发风险也很高.
- 自最后一次类固醇注射以来的时间是分层重复风险的关键因素UC患者与EH.
- 对于UC患者的临床决策EH应纳入自他们最后一次使用类固醇以来的持续时间,以优化管理策略.
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