性结肠炎的长期临床结果与同时进行内镜和组织学缓解
Ji Min Lee1, Kang-Moon Lee1, Dae Bum Kim1
1Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea.
Medicina (Kaunas, Lithuania)
|November 27, 2025
概括
近四分之一的性结肠炎患者实现了内镜和组织学缓解,在四年内复发. 这表明单单双缓解可能无法预测长期结果,因此需要进一步预测性结肠炎管理的预后因素.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 炎症性肠道疾病研究研究
- 临床结果和预后.
背景情况:
- 性结肠炎 (UC) 的治疗目标现在包括粘膜和组织学的愈合,超出症状控制范围.
- 在UC中实现内镜和组织学缓解的长期预后意义尚未得到充分确立,特别是在亚洲人群中.
研究的目的:
- 评估性结肠炎 (UC) 患者的长期结果,这些患者实现了内镜和组织学缓解.
- 为了确定UC患者中复发的预测因素,这些患者获得了双重缓解.
主要方法:
- 对41名成年UC患者进行前性观察性研究,实现内镜 (梅奥得分0) 和组织学 (南西指数≤1) 缓解.
- 收集的数据包括人口统计,临床因素和便calprotectin.
- 患者的随访时间中位数为55个月;复发定义为梅奥得分增加或新的全身治疗开始. 使用卡普兰-梅尔和考克斯回归分析复发风险.
主要成果:
- 24.4%的患者在4年内复发,累计复发率在48个月达到24.1%.
- 在非E1疾病程度 (E2+E3) 和先前使用免疫调节剂或生物制剂的患者中观察到更高的复发率.
- 免疫调节剂和生物使用是复发的显著预测因素 (HR 4.7-4.9);基线便calprotectin没有统计学意义.
结论:
- 在UC中双重内镜和组织学缓解不能保证长期稳定性,大约四分之一的人在四年内复发.
- 目前的双重缓解目标可能不足以作为唯一的终点,强调需要额外的预后指标.
- 患有广泛疾病或先前接受先进治疗的患者代表高风险子组,需要更密切的监测和个性化管理策略.
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