早期积极治疗对炎症性肠道疾病中长期生化标志物模式的影响
Yu Kyung Jun1,2, Yonghoon Choi1, Cheol Min Shin1,2
1Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
使用生化标志物识别长期炎症性肠病 (IBD) 过程是关键. 克罗恩病的早期积极治疗可能会改善缓解,但这种效果在性结肠炎中没有观察到.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 生物标志物研究 生物标志物研究
背景情况:
- 炎症性肠病 (IBD) 呈现出可变的疾病过程,需要及早识别患有不良结果风险的患者.
- 生物化学标记对于预测克罗恩病 (CD) 和性结肠炎 (UC) 的长期疾病轨迹至关重要.
研究的目的:
- 在IBD中使用C-反应蛋白 (CRP) 和便calprotectin (FCP) 水平对长期疾病过程进行分类.
- 确定与CD和UC患者不同的疾病轨迹相关的临床因素.
主要方法:
- 潜在类混合模型分析了256名CD和635名UC患者的CRP和FCP轨迹.
- 多项逻辑回归评估了确定轨迹和临床变量之间的关联.
主要成果:
- 对于CD和UC都确定了三个不同的轨迹:早期持续缓解,延迟缓解和长期难以实现缓解 (>5年).
- 在CD中,早期免疫调节剂或先进疗法启动与更好的缓解轨迹相关 (分别是CRP和FCP).
- 对于UC,诊断时年轻的年龄和早期免疫调节剂的使用与较差的结果有关,而吸烟与CD中更好的FCP缓解有关.
结论:
- 克罗恩病的早期,积极的医疗治疗可能会促进长期的生化缓解.
- 在性结肠炎中,没有观察到早期积极治疗和长期缓解之间的类似关联.
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