Predictive factors of clinical response in steroid-refractory ulcerative colitis treated with granulocyte-monocyte apheresis  

作　　者：Valeria D'Ovidio Donatella Meo Angelo Viscido Giampaolo Bresci Piero Vernia Renzo Caprilli 

机构地区：[1]Department of Clinical Sciences,Gastrointestinal Unit,Policlinico Umberto I,University of Rome,"La Sapienza",Viale del Policlinico 155,Rome 00161,Italy [2]Gastrointestinal Unit,Azienda Ospedaliera-Universitaria Pisana,Pisa 56100,Italy

出　　处：《World Journal of Gastroenterology》2011年第14期1831-1835,共5页世界胃肠病学杂志（英文版）

摘　　要：AIM:To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA). METHODS:Sixty-nine ulcerative colitis patients (39 F,30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index (CAI),C reactive protein (CRP) level,erythrocyte sedimentation rate (ESR),values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS:In the univariate analysis,CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390,95% Confidence interval (CI):0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline (4 < CAI <7) (OR = 0.770,95% CI:0.425-1.394,Wald 3.747,P = 0.028) proved to be effective as factors predicting clinical response. CONCLUSION:GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.AIM：To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis （GMA）. METHODS：Sixty-nine ulcerative colitis patients （39 F,30 M） dependent upon/refractory to steroids were treated with GMA. Steroid dependency,clinical activity index （CAI）,C reactive protein （CRP） level,erythrocyte sedimentation rate （ESR）,values at baseline,use of immunosuppressant,duration of disease,and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used. RESULTS：In the univariate analysis,CAI （P = 0.039） and ESR （P = 0.017） levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio （OR） = 0.390,95% Confidence interval （CI）：0.176-0.865,Wald 5.361,P = 0.0160] and low CAI levels at baseline （4 CAI 7） （OR = 0.770,95% CI：0.425-1.394,Wald 3.747,P = 0.028） proved to be effective as factors predicting clinical response. CONCLUSION：GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.

关 键 词：Granulocyte-monocyte apheresis Ulcerative colitis Steroid therapy Long-term follow-up Predictive factors 

分 类 号：R574.62[医药卫生—消化系统]