Efficacy of faecal microbiota transplantation in Crohn's disease: a new target treatment?
Efficacy of faecal microbiota transplantation in Crohn's disease: a new target treatment?
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粪便微生物群移植治疗克罗恩病的疗效：新的靶向治疗？
DOI：
10.1111/1751-7915.13536
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发表时间：
2020-01-20
影响因子：
5.7
通讯作者：
Zhang, Faming
中科院分区：
文献类型：
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作者：
Xiang, Liyuan;Ding, Xiao;Zhang, Faming
由于缺乏数据，粪便微生物群移植（FMT）在克罗恩病（CD）中的疗效仍不清楚。本研究旨在评估FMT治疗CD相关临床靶点的价值。在2012年10月至2017年12月期间，使用FMT治疗CD作为注册试验（NCT 01793831）。7个治疗目标包括腹痛、腹泻、便血、发热、激素依赖、肠外瘘和活动性肛周瘘。在每例患者的长期随访期间，将每个目标记录为1（是）或0（否）。主要结局是每个治疗目标的改善率。共有174名患者完成了随访。中位随访时间为43（四分位距，28-59）个月。FMT前总指标的中位数为2分（范围1-4分），FMT后1、3、6、12、24和36个月评分均显著下降（P < 0.001）。FMT后1个月腹痛、腹泻、便血和发热改善率分别为72.7%（101/139）、61.6%（90/146）、76%（19/25）和70.6%（12/17）。此外，50%（10/20）的激素依赖型患者在FMT后实现了无激素缓解。目前的研究结果表明，重要的是要了解的疗效FMT在CD作为一种靶向治疗，特别是腹痛，便血，发热和腹泻。
The efficacy of faecal microbiota transplantation (FMT) in Crohn's disease (CD) remains unclear due to lack of data. This study aimed to assess the value of FMT in treating CD-related clinical targets. The use of FMT for CD as a registered trial (NCT01793831) was performed between October 2012 and December 2017. Seven therapeutic targets included abdominal pain, diarrhoea, hematochezia, fever, steroid-dependence, enterocutaneous fistula and active perianal fistula. Each target was recorded as 1 (yes) or 0 (no) during the long-term follow-up for each patient. The primary outcome was the rate of improvement in each therapeutic target. Overall, 174 patients completed the follow-up. The median follow-up duration was 43 (interquartile range, 28-59) months. The median score of the total targets was 2 (range, 1-4) before FMT, and it decreased significantly at 1, 3, 6, 12, 24 and 36 months after FMT (P < 0.001 respectively). At 1 month after FMT, 72.7% (101/139), 61.6% (90/146), 76% (19/25) and 70.6% (12/17) of patients achieved improvement in abdominal pain, diarrhoea, hematochezia and fever respectively. Furthermore, 50% (10/20) of steroid-dependent patients achieved steroid-free remission after FMT. The present findings indicate that it is important to understand the efficacy of FMT in CD as a targeted therapy, especially for abdominal pain, hematochezia, fever and diarrhoea.