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没有全身毒性的急性严重性结肠炎:一项回顾性多中心队列研究建议改进急性严重性结肠炎的定义
Frederik Ørtoft1,2, Mathilde Jepsen Nissen1,2, Jens Kjeldsen1,2
1Department of Medical Gastroenterology, Odense University Hospital, Odense, Denmark.
不符合传统标准 (非TW ASUC) 的急性严重性结肠炎 (ASUC) 住院患者的结果与符合标准 (TW ASUC) 患者的结果相似. 这表明目前的ASUC定义可能需要更新以反映现代临床实践.
科学领域:
- 胃肠病学 胃肠病学
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 急性严重性结肠炎 (ASUC) 通常通过Truelove和Witts (TW) 标准来定义.
- 当代实践涉及早期干预,导致越来越多的住院ASUC患者不符合TW标准 (非TWASUC).
- 这种非TW ASUC种群的特征不佳.
研究的目的:
- 描述不符合传统TW标准的住院ASUC患者的临床表现和结果.
- 为了比较TW ASUC和非TW ASUC之间的疾病过程和胆管切除率.
主要方法:
- 对因ASUC住院并接受静脉注射皮质类固醇治疗的患者进行了回顾性队列研究.
- 在独立的验证队列中评估1年大肠切除率.
- 对患者人口统计,炎症标志物,治疗使用和预后指数的分析.
主要成果:
- 在109名患者中,有27%的患者不符合TW标准 (非TWASUC).
- 非TW ASUC患者呈现较低的系统性炎症,但具有与TW ASUC患者相比的1年无胆管切除生存率和胆管切除率 (29%对19%).
- 预后指数在两组中都发现了类似的高风险患者,非TW ASUC患者的住院时间更短.
结论:
- 非TW ASUC代表了与TW ASUC可比的疾病过程和结果的情况.
- 这些发现凸显了扩大ASUC定义的必要性,使其与当代临床实践保持一致,并准确地反映疾病的严重程度.
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