摘要
目的探讨溃疡性结肠炎(UC)治疗后黏膜愈合程度与预后的关系。方法确诊为UC并经治疗后获得缓解的患者82例,根据治疗效果评价,分为黏膜愈合组(A组:DAI,0—1分;Geboes,0~1级)、黏膜未愈合组(B组:DAI,0~1分;Geboes,2~5级)。随访2年,内容包括患者的基线资料及0、12、24个月(或)复发时组织学参数、血清学指标(白蛋白、ESR、CRP、ANCA、IL-18、IL-6、IL-15),及再入院、结肠手术、结肠癌发生情况等,评估UC治疗后黏膜愈合程度与预后的关系。结果A、B组复发率及复发时间组间比较差异无统计学意义(P〉0.05),经多因素COX回归分析发现性别(女性)、既往复发、pANCA、基底部浆细胞增多是UC复发的独立危险因素(P〈0.05)。A、B组再入院率[分别为27.5%和44.1%,P=0.018,OR=2.24,95%CI(1.11—3.98)]、结肠切除术发生率[分别为0%和17.6%,P=0.035,OR=5.43,95%CI(2.14—7.64)],组间差异明显,而癌变率[分别为0%和2.7%,P=0.643,OR=3.43,95%CI(0.14—7.64)]组间差异无统计学意义。结论UC治疗后黏膜愈合程度与其预后存在明显的相关性。
Objective To investigate the correlation between mucosal healing after treatment and prognosis of ulcerative colitis ( UC ). Methods UC patients who were remitted after treatment ( n = 82 ) were divided into MH group(A:DAI,O-1 ;C, eboes,0-1 ) and non-MH group (B:DAI,O-1 ;Geboes,2-5) ac- cording to the assessment and were followed up for 2 years. The baseline characteristics, histological parame- ters, serologic indices ( albumin, ESR, CRP, ANCA, IL - 1 13, IL - 6 and IL - 15) at 0,12, 24 months or recurrence and hospitalization, colon surgery, colon cancer were recorded. The correlation between mucosal healing and prognosis were assessed. Results There were no significant differences between group A and B in recurrence rate and recurrence time( P 〉 0. 05 ). The multivariate Cox regression analysis showed that gen- der (female), past recurrence, pANCA and basal plasmacytosis were independent risk factors for recurrence of UC (P 〈0.05). The rebospitalization rate [27.5% (group A) VS 44. 1% (group B) ; P =0. 018; OR=2.24, 95%CI (1.11-3.98)] and colectomy rate [0% (group A) VS 17.6% (group B); P= 0. 035; OR =5.43, 95% CI (2. 14-7.64)] between groups have significant differences, however, rates of cancer I0% (group A) VS 2.7% (group B) ; P --0.643; OR =3.43, 95%CI (0. 14-7.64)] were not significantly different. Conclusion Mucosal healing after treatment is associated with UC prognosis.
出处
《中华消化内镜杂志》
2014年第2期80-83,共4页
Chinese Journal of Digestive Endoscopy
基金
佛山市卫生局医学科研立项课题(2012054)
关键词
结肠炎
溃疡性
危险因素
黏膜愈合
预后
Colitis, ulcerative
Risk factors
Mucosal healing
Prognosis