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JCC:早期联合免疫抑制剂与常规治疗的新发克罗恩病的治疗效果比较

2018-05-20 MedSci MedSci原创

与新诊断的克罗恩病CD患者中的常规管理(升阶梯)相比,早期联合免疫抑制的长期结果降(阶梯治疗)是不明确的。本项研究旨在调查升阶梯/降阶梯试验的参与者的长期结果。

背景:
与新诊断克罗恩病CD患者中的常规管理(升阶梯)相比,早期联合免疫抑制的长期结果降(阶梯治疗)是不明确的。本项研究旨在调查升阶梯/降阶梯试验的参与者的长期结果。

方法:
研究人员回顾性分析了研究中心中所有合格患者的病历资料,记录了患者的临床炎症活动,药物使用情况,住院时间,手术方式和瘘管情况,根据结肠镜结果分为:内镜下缓解,小溃疡或大溃疡。

结果:
使用升阶梯治疗的患者有60名,降阶梯患者有59名。在8年的中位数随访时间中,临床缓解率相似70%vs73%(P=0.85)升阶梯患者的复发时间为5年 要比降阶梯治疗患者更短。62%的升阶梯治疗患者会使用皮质类固醇激素,而在降阶梯治疗患者中这比例只有41%。升阶梯治疗组的抗肿瘤坏死因子用量较高(73%vs54%,P=0.25)住院时间无差异,治疗后粘膜愈合率增加,内镜下粘膜愈合率两者无差异。

结论:
与升阶梯治疗相比,降阶梯治疗在长期随访期间没有导致临床缓解增加。然而,观察到较低的复发率和抗TNF剂和皮质类固醇的使用减少。内镜缓解率,住院率,手术或新瘘管的发生率没有差异。

原始出处:

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    2018-05-27 jklm09
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    2018-05-20 内科新手

    谢谢梅斯提供这么好的信息,学到很多

    0

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