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Cytapheresis re-induces high-rate steroid-free remission in patients with steroid-dependent and steroid-refractory ulcerative colitis 被引量:4
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作者 Masahiro Iizuka Takeshi Etou +2 位作者 Yosuke Shimodaira Takashi Hatakeyama Shiho Sagara 《World Journal of Gastroenterology》 SCIE CAS 2021年第12期1194-1212,共19页
BACKGROUND It is a crucial issue for patients with refractory ulcerative colitis(UC),including steroid-dependent and steroid-refractory patients,to achieve and maintain steroid-free remission.However,clinical studies ... BACKGROUND It is a crucial issue for patients with refractory ulcerative colitis(UC),including steroid-dependent and steroid-refractory patients,to achieve and maintain steroid-free remission.However,clinical studies focused on the achievement of steroid-free remission in refractory UC patients are insufficient.Cytapheresis(CAP)is a non-pharmacological extracorporeal therapy that is effective for active UC with fewer adverse effects.This study comprised UC patients treated with CAP and suggested the efficacy of CAP for refractory UC patients.AIM To clarify the efficacy of CAP in achieving steroid-free remission in refractory UC patients.METHODS We retrospectively reviewed the collected data from 55 patients with refractory UC treated with CAP.We analyzed the following points:(1)Efficacy of the first course of CAP;(2)Efficacy of the second,third,and fourth courses of CAP in patients who experienced relapses during the observation period;(3)Efficacy of CAP in colonic mucosa;and(4)Long-term efficacy of CAP.Clinical efficacy was evaluated using Lichtiger’s clinical activity index or Sutherland index(disease activity index).Mucosal healing was evaluated using Mayo endoscopic subscore.The primary and secondary endpoints were the rate of achievement of steroidfree remission and the rate of sustained steroid-free remission,respectively.Statistical analysis was performed using the paired t-test and chi-squared test.RESULTS The rates of clinical remission,steroid-free remission,and poor effectiveness after CAP were 69.1%,45.5%,and 30.9%,respectively.There were no significant differences in rate of steroid-free remission between patients with steroiddependent and steroid-refractory UC.The mean disease activity index and Lichtiger’s clinical activity index scores were significantly decreased after CAP(P<0.0001).The rates of steroid-free remission after the second,third,and fourth courses of CAP in patients who achieved steroid-free remission after the first course of CAP were 83.3%,83.3%,and 60%,respectively.Mucosal healing was observed in all patients who achieved steroid-free remission after the first course of CAP.The rates of sustained steroid-free remission were 68.0%,60.0%,and 56.0%at 12,24,and 36 mo after the CAP.Nine patients(36%)had maintained steroid-free remission throughout the observation period.CONCLUSION Our results suggest that CAP effectively induces and maintains steroid-free remission in refractory UC and re-induces steroid-free remission in patients achieving steroid-free remission after the first course of CAP. 展开更多
关键词 Ulcerative colitis CYTAPHERESIS steroid-dependent STEROID-REFRACTORY Steroid-free remission Inflammatory bowel disease
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Evaluation of 5 versus 10 granulocyteaphaeresis sessions in steroid-dependent ulcerative colitis: A pilot, prospective, multicenter, randomized study 被引量:4
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作者 Elena Ricart Maria Esteve +6 位作者 Montserrat Andreu Francesc Casellas David Monfort Miquel Sans Natalia Oudovenko Raúl Lafuente Julián Panés 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第15期2193-2197,共5页
AIM: To evaluate the efficacy of 5 compared to :tO granulocyteaphaeresis sessions in patients with active steroid-dependent ulcerative colitis. METHODS: In this pilot, prospective, multicenter randomized trial, 20 ... AIM: To evaluate the efficacy of 5 compared to :tO granulocyteaphaeresis sessions in patients with active steroid-dependent ulcerative colitis. METHODS: In this pilot, prospective, multicenter randomized trial, 20 patients with moderately active steroid-dependent ulcerative colitis were randomized to 5 or 10 granulocyteaphaeresis sessions. The primary objective was clinical remission at wk 17. Secondary measures included endoscopic remission and steroid consumption.RESULTS: Nine patients were randomized to 5 granulocyteaphaeresis sessions (group 1) and 11 patients to 10 granulocyteaphaeresis sessions (group 2). At wk 17, 37.5% of patients in group 1 and 45.45% of patients in group 2 were in clinical remission. Clinical remission was accompanied by endoscopic remission in all cases. Eighty-six percent of patients achieving remission were steroid-free at wk 17. Daily steroid requirements were significantly lower in group 2. Eighty-nine per cent of patients remained in remission during a one year follow-up. One serious adverse event, not related to the study therapy, was reported. CONCLUSION: Granulocyteaphaeresis is safe and effective for the treatment of steroid-dependent ulcerative colitis. In this population, increasing the number of aphaeresis sessions is not associated with higher remission rates, but affords a significant steroid-sparing effect. 展开更多
关键词 Ulcerative colitis Granulocyteaphaeresis steroid-dependence Inflammatory bowel diease treatment
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他克莫司联合复方甘草酸苷治疗阴囊激素依赖性皮炎疗效观察 被引量:9
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作者 彭圣炽 李玉良 《中国皮肤性病学杂志》 CAS 北大核心 2012年第11期1053-1054,共2页
目的观察他克莫司软膏联合复方甘草酸苷治疗阴囊激素依赖性皮炎的疗效。方法 79例患者随机分成两组,口服复方甘草酸苷50mg3次/d;对照组外用维生素E乳膏,治疗组外用他克莫司软膏,均2次/d,30d为一疗程。结果治疗组有效率为86.84%,对照组为... 目的观察他克莫司软膏联合复方甘草酸苷治疗阴囊激素依赖性皮炎的疗效。方法 79例患者随机分成两组,口服复方甘草酸苷50mg3次/d;对照组外用维生素E乳膏,治疗组外用他克莫司软膏,均2次/d,30d为一疗程。结果治疗组有效率为86.84%,对照组为48.78%,两组比较差异有统计学意义(P<0.05)。结论他克莫司软膏联合复方甘草酸苷治疗阴囊激素依赖性皮炎优于对照组,是一种可选用于治疗阴囊激素依赖性皮炎的较安全、有效的方法。 展开更多
关键词 阴囊皮炎 激素依赖性 复方甘草酸苷 他克莫司
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氟芬那酸丁酯软膏联合肤痒颗粒治疗阴囊激素依赖性皮炎临床观察 被引量:9
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作者 李玉良 彭圣炽 《中国皮肤性病学杂志》 CAS 北大核心 2010年第11期1078-1078,1080,共2页
目的探讨氟芬那酸丁酯软膏联合肤痒颗粒治疗阴囊激素依赖性皮炎的疗效。方法 85例患者随机分成两组,均口服肤痒颗粒12g/次,3次/d,治疗组外用氟芬那酸丁酯软膏,2次/d,对照组外用维生素E乳膏,2次/d。结果治疗组的有效率达88.89%,对照组为5... 目的探讨氟芬那酸丁酯软膏联合肤痒颗粒治疗阴囊激素依赖性皮炎的疗效。方法 85例患者随机分成两组,均口服肤痒颗粒12g/次,3次/d,治疗组外用氟芬那酸丁酯软膏,2次/d,对照组外用维生素E乳膏,2次/d。结果治疗组的有效率达88.89%,对照组为52.50%,两组比较差异有统计学意义(P<0.05)。结论氟芬那酸丁酯软膏联合肤痒颗粒治疗阴囊激素依赖性皮炎安全、有效。 展开更多
关键词 阴囊激素依赖性皮炎 肤痒颗粒 氟芬那酸丁酯
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A subset of ulcerative colitis with positive proteinase-3 antineutrophil cytoplasmic antibody 被引量:2
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作者 Jin Xu Chuan-Hua Yang +3 位作者 Xiao-Yu Chen Xu-Hang ki Min Dai Shu-Dong Xiao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2008年第45期7012-7015,共4页
A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies. We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANC... A small subset of patients with active ulcerative colitis is non-responsive to major known non-biological therapies. We reported 5 patients with positive serum proteinase-3 antineutrophil cytoplasmic antibody (PR3-ANCA) and tried to (1) identify the common clinical features of these patients; (2) investigate the efficacy of a novel therapy using a Chinese medicine compound; and (3) attract more gastroenterologists to be engaged in further study of this subset of patients. The common manifestations of disease in these 5 patients included recurrent bloody diarrhea and inflammatory lesions involving the entire colorectal mucosa. Initial treatment with intravenous methylprednisolone successfully induced remission. Four of these 5 patients were steroid-dependence, and immunosuppressants, such as azathioprine and cyclophosphamide, were in effective. In 3 patients, only the particular Chinese medicine compound could induce and maintain remission. One patient underwent colectomy. No vascular inflammatory lesions were found by histopathological examination. Although more cases are needed for confirmation, our study indicates thatulcerative colitis with positive PR3-ANCA may belong to a subtype of refractory ulcerative colitis. The particular Chinese medicine compound used in our study is by far the most effective in the management of these patients, with additional advantages of having no noticeable side-effects and less financial burden. 展开更多
关键词 Refractory ulcerative colitis Proteinase-3 antineutrophil cytoplasmic antibody Methyprednisolone steroid-dependence Chinese medicine
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凉州驴去势引发阴囊炎与破伤风的诊治 被引量:1
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作者 戴命子 李宗财 《畜牧兽医杂志》 2020年第4期92-93,共2页
一3岁凉州驴因去势消毒不严而引发阴囊炎、破伤风。应用破伤风抗毒素配合抗生素、镇静解痉药物静脉注射,痊愈。治疗结果表明,大剂量注射破伤风抗毒素是治愈破伤风的关键;同时,在患畜发病的过程中,由于体质很弱、抵抗力降低,必须应用大... 一3岁凉州驴因去势消毒不严而引发阴囊炎、破伤风。应用破伤风抗毒素配合抗生素、镇静解痉药物静脉注射,痊愈。治疗结果表明,大剂量注射破伤风抗毒素是治愈破伤风的关键;同时,在患畜发病的过程中,由于体质很弱、抵抗力降低,必须应用大剂量的抗生素控制感染和并发症,才能提高疗效、缩短疗程。 展开更多
关键词 凉州驴 破伤风 阴囊炎 诊断 治疗
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