溃疡性结肠炎治疗后内镜下不同进展情况的预测因素

Predictors of endoscopic progression of ulcerative colitis after treatment

背景溃疡性结肠炎(ulcerative colitis,UC)患者粪便中部分蛋白、外周血实验室指标与黏膜愈合等预后有关.但目前关于UC治疗前各项临床指标与治疗后内镜下进展的关系并未完全明确.UC内镜严重程度指数(UC endoscopic index of severity,UCEIS)是评估UC疗效的重要工具,包含了血管形态、出血、糜烂与溃疡3个项目.本研究通过分析溃疡性结肠炎治疗后内镜下不同进展情况的因素,以便临床医生更好的预测疗效.目的分析UC治疗后内镜下不同进展情况的预测因素.方法选择杭州市第九人民医院收治的UC患者156例,按照治疗后内镜下血管形态、出血、糜烂与溃疡是否进展,分为进展组与未进展组,收集并比较两组各项临床指标的差异,采用Logistic回归模型分析UC治疗后内镜下进展的影响因素.结果血管形态进展组与未进展组治疗前血清白蛋白、C-反应蛋白(C-reactive protein,CRP)以及血小板体积比较,差异有统计学意义(P<0.05).出血进展组与未进展组治疗前病变范围、血小板体积以及血小板计数比较,差异有统计学意义(P<0.05).糜烂与溃疡进展组与未进展组治疗前CRP以及红细胞沉降率比较,差异有统计学意义(P<0.05).血清白蛋白、CRP以及血小板体积与UC治疗后内镜下血管形态进展有关,血小板体积、血小板计数与出血进展有关,CRP、红细胞沉降率与糜烂与溃疡进展有关,差异均有统计学意义(P<0.05).结论UC治疗前血清白蛋白、CRP、血小板体积、血小板计数以及红细胞沉降率与治疗后内镜下不同项目进展有关,且对预测内镜下进展有一定价值.

BACKGROUND Some proteins in stool and peripheral blood indexes are related to the prognosis of mucosal healing in patients with ulcerative colitis(UC).However,at present,the relationship between clinical indicators before UC treatment and endoscopic progression after treatment is not completely clear.UC endoscopic index of severity(UCEIS)is an important tool to evaluate the therapeutic efficacy for UC,and it is comprised of three descriptors:Vascular morphology,bleeding,erosion and ulcer.In this study,we analyzed the factors affecting the endoscopic progression of UC after treatment so that clinicians could better predict the curative effect.AIM To identify the predictive factors for endoscopic progression of UC after treatment.METHODS A total of 156 UC patients admitted to the Ninth People’s Hospital of Hangzhou were selected and divided into either a progression group or a non-progression group according to whether endoscopic progression occurred after treatment.The differences in various clinical indicators were compared between the two groups,and factors affecting endoscopic progression of UC after treatment were identified using a logistic regression model.RESULTS Serum albumin,C-reactive protein,and platelet volume at baseline differed significantly between the vascular morphology progression group and the non-progression group(P<0.05).Lesion range,platelet volume,and platelet count at baseline were significantly different between the bleeding progression group and the non-progression group(P<0.05).C-reactive protein(CRP)and erythrocyte sedimentation rate at baseline differed significantly between the erosion and ulcer progression group and the non-progression group(P<0.05).Serum albumin,CRP,and platelet volume were significantly related to the progression of vascular morphology,platelet volume and platelet count were related to the progression of bleeding,and CRP and erythrocyte sedimentation rate were related to the progression of erosion and ulcer in UC after treatment(P<0.05).CONCLUSION Serum albumin,CRP,platelet volume,platelet count,and erythrocyte sedimentation rate before UC treatment are related to different aspects of endoscopic progression of UC after treatment,and they have appreciated value in predicting the endoscopic progression of UC after treatment.