在性结肠炎中出现正常或接近正常的组织学时,药物停用与临床复发有关
Seth R Shaffer1,2, Jenny Chu3, Amal Algarni3
1Department of Internal Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences.
性结肠炎 (UC) 患者的组织结构达到正常水平,有中度的复发风险,特别是如果他们停止IBD治疗. 在这项研究中,肌肉发育不良的风险为零.
科学领域:
- 胃肠病学 胃肠病学
- 炎症性肠道疾病 炎症性肠病
- 组织病理学 组织病理学
背景情况:
- 性结肠炎 (UC) 的组织学缓解与更好的临床结果相关.
- 了解UC患者正常化组织学的长期临床过程和形风险至关重要.
研究的目的:
- 评估性结肠炎患者的临床过程和形风险,这些患者几乎或完全实现了组织学正常化.
- 评估IBD治疗停止对UC患者正常化组织学的临床复发率的影响.
主要方法:
- 对UC患者进行了回顾性单中心研究,这些患者在内镜缓解中具有正常的组织学.
- 专家病理学家对病理学幻灯片和右结肠和左结肠的Geboes评分进行了审查.
- 主要结局:临床复发的时间;次要结局:发育不良和切除术.
主要成果:
- 在78名患者中,只有2名在专家审查后具有完全正常的组织学.
- 大约20%的患者经历了临床复发,平均4.7年.
- 停止IBD治疗与临床复发风险显著增加有关 (HR:4.89).
- 观察到零发症的发育不良;2个复发的患者接受了切除术.
结论:
- 性结肠炎患者达到正常或接近正常的组织学面临中度的临床复发率.
- 建议在停止IBD治疗时谨慎使用,因为它会增加复发风险.
- 仅仅基因组学正常化可能无法完全预测UC的长期结果.
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