溃疡性结肠炎患者首次糖皮质激素治疗后1年内复发预测因子分析

Analysis of relapsepredict factors in the ulcerative colitis cases after initial corticosteroid therapy

[目的]探讨溃疡性结肠炎（U C ）患者首次糖皮质激素治疗后1年内复发情况及其预测因子。[方法]对37例首次接受糖皮质激素治疗、随访1年或者1年内因复发再次入院的U C患者的资料进行回顾性分析。[结果]37例U C患者中，1年内复发者（A组）19例（51％），平均复发时间为开始使用糖皮质激素后5.0个月；1年复发者（B组）18例，占49％。与B组相比，A组全结肠型U C患者比例明显较高（50％∶90％），差异有统计学意义（ P＝0.009）。单变量分析提示全结肠型U C与开始糖皮质激素治疗后1年内的复发显著相关（ P＝0.009），多变量分析也提示全结肠型UC与1年内复发显著相关（P＝0.037，OR：12.006，95％ CI：1.163～123.959）。[结论]UC患者首次接受糖皮质激素治疗诱导缓解后，1年内复发率仍较高；全结肠型UC与开始糖皮质激素治疗后1年内复发相关。

[Objective]To identify the incidence of relapse and its early predictors in the ulcerative colitis （UC）cases after initial corticosteroid（CS）therapy.[Methods] A retrospective analysis was conducted in 37 cases which were followed up at outpatient department for at least 1 year ,or relapsed within 1 year after start of CS.[Results] In the 37 UC cases ,19 cases（51% ）relapsed within 1 year ,and the average relapse time was 5.0 months after start of CS.In univariate analysis ,extensive colitis was significantly correlated with the relapse（P=0.009）.In multivariate analysis by using the Logistic regression model ,extensive coli-tis also had a significant correlation with the relapse （P=0.037 ,OR：12.006 ,95% CI：1.163-123.959）.[Conclusion]In UC cases with initial CS therapy ,the relapse rate（59% ）is still high within 1 year despite of immediate remission after start of CS.Extensive colitis at baseline predicts the relapse within 1 year after start of CS.