POUCHITIS AFTER ILEAL POUCH-ANAL ANASTOMOSIS - A POUCHITIS DISEASE-ACTIVITY INDEX
POUCHITIS AFTER ILEAL POUCH-ANAL ANASTOMOSIS - A POUCHITIS DISEASE-ACTIVITY INDEX
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DOI：
10.1016/s0025-6196(12)61634-6
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发表时间：
1994-05-01
影响因子：
8.9
通讯作者：
PHILLIPS, SF
中科院分区：
文献类型：
--
作者：
SANDBORN, WJ;TREMAINE, WJ;PHILLIPS, SF
目的：设计：我们比较了马约诊所溃疡性结肠炎回肠袋-肛门吻合术（IPAA）后复发性结肠袋炎的患者和具有最佳结果的患者。材料和方法：我们评估了PDAI的适用性，该PDAI定量了四组患者的临床表现以及急性炎症的内镜和组织学特征：（1）10例因溃疡性结肠炎接受了IPAA，症状与结肠袋炎的临床诊断相符，（2）5例因溃疡性结肠炎接受了IPAA，没有结肠袋炎，（3）5例因家族性腺瘤性息肉病而行IPAA且无结肠袋炎症状者，（4）5例因溃疡性结肠炎而行布鲁克回肠造口术者（对照组）。所有10例结肠袋炎患者均符合诊断结肠袋炎的PDAI标准;相比之下，通过应用先前建立的评分系统，这10例患者中仅1例符合结肠袋炎的诊断标准。没有无症状的患者合格的诊断袋炎的PDAI criteris.Conclusion：PDAI提供了简单，客观，定量标准IPAA后袋炎症，比以前的评分系统更敏感。
Objective: To develop a ''Pouchitis Disease Activity Index'' (PDAI) and to compare it with other diagnostic scoring systems for pouchitis.Design: We compared patients who had an optimal outcome with those who had a poor result attributable to recurrent pouchitis after ileal pouch-anal anastomosis (IPAA) for ulcerative colitis at the Mayo Clinic.Material and Methods: We evaluated the applicability of a PDAI that quantitated clinical findings and the endoscopic and histologic features of acute inflammation in four groups of patients: (1) 10 who underwent IPAA for ulcerative colitis and had symptoms compatible with a clinical diagnosis of pouchitis, (2) 5 who underwent IPAA for ulcerative colitis and did not have pouchitis, (3) 5 who underwent IPAA for familial adenomatous polyposis and had no symptoms of pouchitis, and (4) 5 who had a Brooke ileostomy for ulcerative colitis (control group).Results: The PDAI was significantly greater in patients with the clinical features of pouchitis than it was for patients in the other three groups. All 10 patients with pouchitis fulfilled the PDAI criteria for a diagnosis of pouchitis; in contrast, only 1 of these 10 patients met the diagnostic criteria for pouchitis by application of previously established scoring systems. No asymptomatic patient qualified for a diagnosis of pouchitis by the PDAI criteria.Conclusion: The PDAI provides simple, objective, and quantitative criteria for pouch inflammation after IPAA and is more sensitive than prior scoring systems.