溃疡性结肠炎治疗后黏膜愈合程度与预后的关系的研究  

The correlation between mucosal healing and prognosis of ulcerative colitis

作　　者：李匡一[1] 张亚历[1] 崔西玉[2] 李兆滔[2] 陈曼彤[2] 

机构地区：[1]南方医科大学南方医院消化内科,广州510515 [2]佛山市第一人民医院消化内科

出　　处：《中华消化内镜杂志》2014年第2期80-83,共4页Chinese Journal of Digestive Endoscopy

基　　金：佛山市卫生局医学科研立项课题（2012054）

摘　　要：目的探讨溃疡性结肠炎（UC）治疗后黏膜愈合程度与预后的关系。方法确诊为UC并经治疗后获得缓解的患者82例，根据治疗效果评价，分为黏膜愈合组（A组：DAI，0—1分；Geboes，0～1级）、黏膜未愈合组（B组：DAI，0～1分；Geboes，2～5级）。随访2年，内容包括患者的基线资料及0、12、24个月（或）复发时组织学参数、血清学指标（白蛋白、ESR、CRP、ANCA、IL-18、IL-6、IL-15），及再入院、结肠手术、结肠癌发生情况等，评估UC治疗后黏膜愈合程度与预后的关系。结果A、B组复发率及复发时间组间比较差异无统计学意义（P〉0．05），经多因素COX回归分析发现性别（女性）、既往复发、pANCA、基底部浆细胞增多是UC复发的独立危险因素（P〈0．05）。A、B组再入院率[分别为27．5％和44．1％，P=0．018，OR=2．24，95％CI（1．11—3．98）]、结肠切除术发生率[分别为0％和17．6％，P=0．035，OR=5．43，95％CI（2．14—7．64）]，组间差异明显，而癌变率[分别为0％和2．7％，P=0．643，OR=3．43，95％CI（0．14—7．64）]组间差异无统计学意义。结论UC治疗后黏膜愈合程度与其预后存在明显的相关性。Objective To investigate the correlation between mucosal healing after treatment and prognosis of ulcerative colitis （ UC ）. Methods UC patients who were remitted after treatment （ n = 82 ） were divided into MH group（A：DAI,O-1 ;C, eboes,0-1 ） and non-MH group （B：DAI,O-1 ;Geboes,2-5） ac- cording to the assessment and were followed up for 2 years. The baseline characteristics, histological parame- ters, serologic indices （ albumin, ESR, CRP, ANCA, IL - 1 13, IL - 6 and IL - 15） at 0,12, 24 months or recurrence and hospitalization, colon surgery, colon cancer were recorded. The correlation between mucosal healing and prognosis were assessed. Results There were no significant differences between group A and B in recurrence rate and recurrence time（ P 〉 0. 05 ）. The multivariate Cox regression analysis showed that gen- der （female）, past recurrence, pANCA and basal plasmacytosis were independent risk factors for recurrence of UC （P 〈0.05）. The rebospitalization rate [27.5% （group A） VS 44. 1% （group B） ; P =0. 018; OR=2.24, 95%CI （1.11-3.98）] and colectomy rate [0% （group A） VS 17.6% （group B）; P= 0. 035; OR =5.43, 95% CI （2. 14-7.64）] between groups have significant differences, however, rates of cancer I0% （group A） VS 2.7% （group B） ; P --0.643; OR =3.43, 95%CI （0. 14-7.64）] were not significantly different. Conclusion Mucosal healing after treatment is associated with UC prognosis.

关 键 词：结肠炎 溃疡性 危险因素 黏膜愈合 预后 

分 类 号：R574.62[医药卫生—消化系统]