The natural history of corticosteroid therapy for inflammatory bowel disease: A population-based study
The natural history of corticosteroid therapy for inflammatory bowel disease: A population-based study
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DOI：
10.1053/gast.2001.26279
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发表时间：
2001-08-01
期刊：
影响因子：
29.4
通讯作者：
Sandborn, WJ
中科院分区：
文献类型：
--
作者：
Faubion, WA;Loftus, EV;Sandborn, WJ
背景与目的本研究的目的是确定炎症性肠病患者首次接受皮质类固醇治疗后1年的预后。方法。从1970年到1993年，明尼苏达州奥姆斯特德县所有被诊断为克罗恩病（n = 173）或溃疡性结肠炎（n = 185）并接受全身性皮质类固醇治疗的患者被确定（4例被拒绝研究授权）。测定第一疗程后的即时预后（30天）和1年预后。结果：74例（43%）克罗恩病患者和63例（34%）溃疡性结肠炎患者接受了皮质类固醇治疗。克罗恩病的直接预后为完全缓解43例（58%），部分缓解19例（26%），无缓解12例（16%），溃疡性结肠炎的直接预后为完全缓解34例（54%），部分缓解19例（30%），无缓解10例（16%）。克罗恩病的1年预后为延长缓解24例（32%），皮质类固醇依赖21例（28%），手术28例（38%），失访1例（1%）。溃疡性结肠炎的1年预后为延长缓解31例（49%），皮质类固醇依赖14例（22%），手术18例（29%）。结论：大多数克罗恩病和溃疡性结肠炎患者最初对皮质类固醇有反应。1年后，32%的克罗恩病患者和48%的溃疡性结肠炎患者无需手术即可使用皮质类固醇。
Background & Aims. The aim of this study was to determine the 1-year outcome after the first course of corticosteroids in an inception cohort of patients with inflammatory bowel disease. Methods. All patients in Olmsted County, Minnesota, diagnosed with Crohn's disease (n = 173) or ulcerative colitis (n = 185) from 1970 to 1993 who were treated with systemic corticosteroids were identified (4 denied research authorization). Immediate outcome (30 days) and 1-year outcome after the first course of corticosteroids were determined. Results: Seventy-four (43%) patients with Crohn's disease and 63 (34%) with ulcerative colitis were treated with corticosteroids. Immediate outcomes for Crohn's disease were complete remission in 43 (58%), partial remission in 19 (26%), and no response in 12 (16%), Immediate outcomes for ulcerative colitis were complete remission in 34 (54%), partial remission in 19 (30%), and no response in 10 (16%). One-year outcomes for Crohn's disease were prolonged response in 24 (32%), corticosteroid dependence in 21 (28%), operation in 28 (38%), and lost to follow-up in 1 (1%). One-year outcomes for ulcerative colitis were prolonged response in 31 (49%), corticosteroid dependence in 14 (22%), and operation in 18 (29%). Conclusions: Most patients with Crohn's disease and ulcerative colitis initially respond to corticosteroids. At I year, 32% of patients with Crohn's disease and 48% with ulcerative colitis are corticosteroid free without operation.