在性结肠炎中对皮质类固醇的临床反应的动态变化
Beatriz Gros1,2,3, Marina Orti Cuerva1, María Auxiliadora Valenzuela García1
1Gastroenterology and Hepatology Department, Reina Sofía University Hospital, University of Cordoba, Cordoba, Spain.
皮质类固醇对性结肠炎 (UC) 的反应是动态的;超过三分之一的不响应者持续. 诸如肠外表现和疾病程度等因素预测了对UC治疗的更好的反应.
科学领域:
- 胃肠病学 胃肠病学
- 临床药理学 临床药理学
- 炎症性肠道疾病研究研究
背景情况:
- 皮质类固醇是性结肠炎 (UC) 爆发的关键.
- 许多UC患者缺乏反应或成为类固醇依赖.
- 在UC中长期的皮质类固醇反应模式尚不清楚.
研究的目的:
- 分析UC患者在多次治疗过程中对皮质类固醇反应的变化动态.
- 确定影响皮质类固醇反应和UC不响应的因素.
主要方法:
- 成年UC患者 (1975-2023) 接受≥2个皮质类固醇疗程的回顾性队列研究.
- 通过部分梅奥评分 (PMS) 评估治疗反应.
- 马尔科夫建模用于分析响应状态转换和识别相关因素.
主要成果:
- 571名UC患者中有201人符合纳入标准;分析了899个皮质类固醇疗程.
- 在随访期间,44.3%的患者没有反应,41.8%的患者患上了类固醇依赖.
- 没有反应的持续性概率为37.8%,完全反应的持续性为79.5%. 肠道感染,贝克洛美沙使用,肠外表现和疾病扩散是重要因素.
结论:
- 在UC中皮质类固醇反应是一个动态的过程,而不是静态的.
- 很大一部分UC患者最初没有反应,但在随后的疗程中仍然没有反应.
- 肠外表现,皮质类固醇类型 (普雷尼松与贝克洛梅他松),以及更大的疾病延伸影响UC皮质类固醇反应的可能性.
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