Long-term evolution of gut inflammation in patients with spondyloarthropathy
Long-term evolution of gut inflammation in patients with spondyloarthropathy
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DOI：
10.1053/gast.1996.v110.pm8964393
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发表时间：
1996-06-01
期刊：
影响因子：
29.4
通讯作者：
Veys, E
中科院分区：
文献类型：
--
作者：
DeVos, M;Mielants, H;Veys, E
背景与目的：在脊椎关节病（SpA）患者中观察到肠道炎症。这项前瞻性研究报道了SpA患者肠道炎症的演变。方法:对123例初次行内镜检查的SpA患者进行临床再评估，其中49例患者通过回肠结肠镜检查和活检标本组织学研究评估肠道演变。结果关节缓解率与初次肠道炎症无关，且与内镜和组织学缓解相关，活动性关节疾病患者可观察到持续的肠道炎症，肠道炎症很少消失。尽管持续存在关节不适。最初的慢性肠道炎症意味着发展为强直性脊柱炎的高风险，在7%的患者中观察到发展为炎症性肠病（IBD）。主要是初始慢性炎症和轻度腹泻的患者有It风险，磺胺氮嗪更常用于治疗肠道炎症的患者，对关节和肠道的演变有有益的作用，但不能防止演变为IBD。结论：本研究支持肠道在SpA中的致病作用，慢性肠道炎症和轻度腹泻的存在意味着发展为强直性脊柱炎和BED的高风险。柳氮磺胺吡啶通过控制肠道炎症对关节活动有有益作用，但它不能阻止进化为显性IBD。
Background & Aims: Intestinal inflammation has been observed in patients with spondyloarthropathy (SpA). This prospective study reports the evolution of the intestinal inflammation observed in patients with SpA. Methods: One hundred twenty-three patients with SpA who had undergone initial endoscopy were clinically reassessed, intestinal evolution was evaluated by ileocolonoscopy and the histological study of biopsy specimens in 49 patients, Results Articular remission rates were independent of initial gut inflammation and associated with endoscopic and histological remission, Persistent gut inflammation was observed in active joint disease, Gut inflammation rarely disappeared, despite the persistence of articular complaints. Initial chronic gut inflammation implied a high risk of evolution to ankylosing spondylitis, Evolution to inflammatory bowel disease (IBD) was observed in 7% of patients. Mainly patients with initial:chronic inflammation and mild complaints of diarrhea were It risk, Sulfasalazine was more frequently needed in the treatment of patients with gut inflammation with a beneficial effect on articular and intestinal evolution but did not prevent evolution to IBD. Conclusions: This study supports the etiopathogenetic role of the gut in SpA, Presence of chronic gut inflammation and mild complaints of diarrhea implies a high risk of evolution to ankylosing spondylitis and BED. Sulfasalazine has a beneficial effect on articular activity by controlling gut inflammation, but it cannot prevent evolution to overt IBD.