来自亚洲的急性严重性结肠炎患者的结肠切除风险低于来自澳大利亚的患者
Richard Gareth Fernandes1, Dong Hyun Kim2, Leonie Ruddick-Collins3
1Department of Gastroenterology and Hepatology, Mater Hospital Brisbane, Brisbane, Australia; Mater Research Institute The University of Queensland, South Brisbane, Australia.
概括
与澳大利亚和新西兰 (ANZ) 患者相比,患有急性严重性结肠炎 (ASUC) 的亚洲患者表现出明显的特征和更好的治疗反应. 这包括较低的胆管切除率和减少对先进疗法的需求,尽管疾病更广泛.
科学领域:
- 胃肠病学 胃肠病学
- 临床流行病学 临床流行病学
- 炎症性肠道疾病研究研究
背景情况:
- 性结肠炎 (UC) 和急性严重性结肠炎 (ASUC) 的发病率在亚洲正在上升,但仍然低于澳大利亚和新西兰 (ANZ).
- 亚洲研究表明,UC具有独特的特征,并降低了胆管切除术的风险.
- 由于ASUC的区域差异很大,因此需要进行比较研究.
研究的目的:
- 为了比较亚洲急性严重性结肠炎 (ASUC) 患者的临床特征和治疗结果,与ANZ.
- 为了确定这些地理区域之间的疾病呈现,管理和切除率的差异.
主要方法:
- 多国,多中心的回顾性队列研究.
- 包括2015年1月至2020年12月连续住院患者的ASUC (Truelove和Witts的标准).
- 数据来自4个亚洲国家的14家医院和9个ANZ医院.
主要成果:
- 包括861名患者 (430名亚洲人,431名ANZ人) 具有不同的基线特征.
- 亚洲队列呈现出更广泛的疾病和更严重的内镜严重性,但IBD家族史较低.
- 亚洲患者在入院前接受的先进疗法较少,表现较低的皮质类固醇失效率 (21.5%vs57.2%),并显著降低住院患者 (2.8%vs10.9%) 和1年大肠切除率 (4.7%vs22.5%).
结论:
- 在亚洲和ANZ之间,ASUC患者特征存在显著差异.
- 尽管疾病呈现更严重,但亚洲ASUC队列表现出优越的皮质类固醇反应.
- 与ANZ相比,在亚洲ASUC患者中观察到较低的胆管切除率和对先进疗法的依赖性降低.
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