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第三天 牛津标准预测在后生物学时代急性严重性结肠炎的类固醇不响应
Sudheer K Vuyyuru1, Lotus Alphonsus2, Theshani Amalka De Silva2
1Department of Medicine, Division of Gastroenterology, Western University, London, Ontario, Canada.
第三天的牛津标准有效地预测了急性严重性结肠炎 (ASUC) 患者的类固醇无反应. 尽管最初接受了类固醇治疗,但切除术后的风险仍然很大,这凸显了密切监测的必要性.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 炎症性肠病研究研究
背景情况:
- 在后生物学时代,急性严重性结肠炎 (ASUC) 患者的结果需要进一步调查.
- 目前在ASUC中预测早期类固醇不响应的评分指数的预测能力尚未得到充分证实.
研究的目的:
- 探索在后生物学时代住院治疗ASUC患者的结果.
- 评估评分指数预测早期类固醇不响应的能力.
主要方法:
- 一个回顾性队列研究的成年人住院治疗ASUC在2010-2022年之间.
- 在住院期间以及在3个月和12个月的随访期间评估类固醇反应,救援疗法和小肠切除率.
- 后勤回归分析,以确定类固醇不响应的预测因素.
主要成果:
- 55.7%的患者对静脉输入的皮质类固醇有反应;37.9%需要救援治疗.
- 8%的患者在指数住院期间接受了切除术,另外11.6%的患者在出院后12个月内需要切除术.
- 第三天的牛津标准是唯一可预测类固醇无反应的重要预测因素 (OR 4.70).
结论:
- 第三天牛津标准独立预测ASUC中的类固醇不响应.
- 退院后仍然存在大量的胆管切除风险,尽管医院内胆管切除率较低.
- 最初的类固醇反应没有影响12个月后的长期胆管切除率.
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