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英夫利昔单抗作为重度或中重度溃疡性结肠炎的补救疗法:一项随机、安慰剂对照试验 被引量:4
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作者 jrnerot g. Hertervig E. +1 位作者 Friis-Liby I. 王铮 《世界核心医学期刊文摘(胃肠病学分册)》 2005年第10期25-26,共2页
Background &Aims: Despite treatment with corticosteroids, severe to moderately severe attacks of ulcerative colitis have a high colectomy rate. We intended to find a rescue therapy other than cyclosporin A, which ... Background &Aims: Despite treatment with corticosteroids, severe to moderately severe attacks of ulcerative colitis have a high colectomy rate. We intended to find a rescue therapy other than cyclosporin A, which imposes a high risk of side effects and cyclosporine-related mortality. Methods: This was a randomized double-blind trial of infliximab or placebo in severe to moderately severe ulcerative colitis not responding to conventional treatment. Patients were randomized to infliximab/ placebo either on day 4 after the initiation of corticosteroid treatment if they fulfilled the index criteria for fulminant ulcerative colitis on day 3 or on day 6-8 if they fulfilled index criteria on day 5-7 for a severe or moderately severe acute attack of ulcerative colitis. Results were analyzed according to the intention-to-treat principle. The primary end point was colectomy or death 3 months after randomization. Secondary end points were clinical and endoscopic remission at that time in patients who did not undergo operation. Results: Forty-five patients were included (24 infliximab and 21 placebo). No patient died. Seven patients in the infliximab group and 14 in the placebo group had a colectomy (P =. 017; odds ratio, 4.9; 95%confidence interval, 1.4-17) within 3 months after randomization. No serious side effects occurred. Three patients in the placebo group required operation for septic complications. Conclusions: Infliximab 4-5 mg/kg is an effective and safe rescue therapy in patients experiencing an acute severe or moderately severe attack of ulcerative colitis not responding to conventional treatment. 展开更多
关键词 溃疡性结肠炎 安慰剂对照 暴发性结肠炎 常规方法治疗 环孢霉素 结肠切除术 药物治疗 皮质类固醇 急性发作 脓毒症
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抗酿酒酵母菌抗体在炎症性肠孪生病患者中的表达
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作者 Halfvarson j. Standaert- Vitse A. +1 位作者 jrnerot g. 郑世成 《世界核心医学期刊文摘(胃肠病学分册)》 2005年第12期36-37,共2页
Background and aims: An increased occurrence of anti- Saccharomyces cerev/s/ae antibodies (ASCA) is reported in unaffected members of families with Crohn’ s disease. Whether ASCA is a familial trait due to genetic fa... Background and aims: An increased occurrence of anti- Saccharomyces cerev/s/ae antibodies (ASCA) is reported in unaffected members of families with Crohn’ s disease. Whether ASCA is a familial trait due to genetic factors or is caused by exposure to environmental factors is unknown. To assess the genetic influence of ASCA we studied its occurrence in a twin population. Patients and methods: ASCA were analysed in 98 twin pairs with inflammatory bowel disease and were related to clinical phenotype and CARD15/NOD2 genotype. Results: ASCA were more common in Crohn’ s disease than in ulcerative colitis (40/70 (57% ) twins v 5/43 (12% ) twins). Associations with ileal Crohn’ s disease, stricturing/ penetrating behaviour, and young age, but not CARD15/NOD2 were confirmed. ASCA were found in 1/20 (5% ) healthy siblings in discordant monozygotic pairs with Crohn’ s disease compared with 7/27 (26% ) in discordant dizygotic pairs. Using the intraclass correlation coefficient (ICC), no agreement in ASCA titres was observed in discordant twin pairs with Crohn’ s disease, in monozygotic (ICC = - 0.02) or dizygotic (ICC = - 0.26) pairs. In contrast, strong agreement was seen within concordant monozygotic twin pairs with Crohn’ s disease (ICC = 0.76). Conclusions: These findings question the concept of ASCA as a marker of genetic susceptibility for Crohn’ s disease. The agreement in ASCA titres within concordant monozygotic twin pairs with Crohn’ s disease, suggests that the level of increase is genetically determined. We propose that ASCA are a marker of a response to an environmental antigen and that a specific gene(s) other than CARD15/NOD2 determines the level of response and perhaps also specific phenotypic characteristics. 展开更多
关键词 克罗恩病 酿酒酵母菌 单卵双生 溃疡性结肠炎 临床表型 组内相关系数 表型特征 CARD 滴度 反应水平
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