对局部类固醇的内镜反应与未来更少食道扩张的需要有关
Timothy S Gee1, Sean S LaFata1, Hannah L Thel1
1Department of Medicine, Division of Gastroenterology and Hepatology, Center for Esophageal Diseases and Swallowing, University of North Carolina School of Medicine, 101 Manning Drive, Chapel Hill, NC 27599, USA.
概括
在局部类固醇治疗 (tCS) 后,获得性食道炎 (EoE) 内镜反应 (EREFS ≤2) 显著减少了未来食道扩张的需要. 这种内镜改善还与EOE患者更好的症状控制和组织学结果相关.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
背景情况:
- 性食道炎 (EoE) 是一种慢性炎症状况.
- 在EoE内镜参考评分 (EREFS) 评估内镜严重性.
- 获得EREFS评分≤2 (内镜反应) 对局部皮质类固醇 (tCS) 的临床意义尚未明确.
研究的目的:
- 为了确定EREFS对tCS的反应是否与EoE患者未来食道扩张的需求减少有关.
- 评估内镜反应与其他临床结果 (如症状和组织学反应) 之间的相关性.
主要方法:
- 对113名EoE患者进行了回顾性队列研究.
- 纳入标准:新的EoE诊断,食道扩张,tCS治疗和≥2次随访内镜检查.
- 内镜反应定义为tCS后的EREFS ≤2;对响应者和非响应者之间的扩张频率,症状和组织学反应进行比较.
主要成果:
- 49%的患者在tCS后获得了内镜反应 (EREFS ≤2).
- 内镜反应者需要较少的扩张 (4.5对6.2;p=0.03) 超过中位数的随访时间 (1106天).
- 受访者表现出明显更好的症状 (92%对64%;p=0.005) 和组织学反应 (82%对24%;p<0.001).
结论:
- 在EoE中对tCS的内镜反应 (EREFS ≤2) 与临床重要结果有关.
- 达到内镜反应与减少食道扩张的需要有关.
- 内镜改善与优越的症状控制和EOE中的组织学分辨率相关.
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