Intestinal permeability test as a predictor of clinical course in Crohn's disease
Intestinal permeability test as a predictor of clinical course in Crohn's disease
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DOI：
10.1111/j.1572-0241.1999.01444.x
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发表时间：
1999-10-01
影响因子：
9.8
通讯作者：
Sturniolo, GC
中科院分区：
文献类型：
--
作者：
D'Incà, R;Di Leo, V;Sturniolo, GC
目的：克罗恩病的临床过程往往是不可预测的。本研究的目的是选择最有用的参数，能够预测临床relations.METHODS：100 - 30克罗恩病患者在临床缓解，每4个月进行随访2年或直到临床复发。记录人口统计学和临床数据，并在研究入组时进行肠通透性（乳果糖/甘露醇[L/M]试验）和生化试验（白色血细胞计数、红细胞沉降率、C-反应蛋白、α 1酸性糖蛋白和血清铁）。一个亚组的54例患者进行了临床随访和重复测试，每4 months.Results：52例（40%）复发，在2年的随访。复发与性别有显著相关性（p = 0.030），但与年龄、疾病程度和类型、既往手术史、sr治疗无关。L/M试验升高（p = 0.0001）和血清铁水平降低（p = 0.0057）与临床复发相关。对接受系列评估的患者进行的时间依赖性分析显示，L/M试验改变是唯一可以预测复发的变量（RR 8.84，95%置信区间[CI] 1.41-53.37; p < 0.05）。L/M试验鉴定明显缓解但临床复发风险高的克罗恩病患者，优于临床和生化指标。不同的治疗策略可能会建议为这个亚组的患者。(C)1999年，我胃肠病学。
OBJECTIVE: The clinical course of Crohn's disease is often unpredictable. The aim of this study was to select the most useful parameters able to predict clinical relapses.METHODS: One hundred-thirty Crohn's disease patients in clinical remission were followed every 4 months for 2 yr or until clinical relapse. Demographic and clinical data were recorded and intestinal permeability (lactulose/mannitol [L/M] test) and biochemical tests (white blood cell count, erythrocyte sedimentation rate, C-reactive protein, alpha 1 acid glycoprotein, and serum iron) were performed at study entry. A subgroup of 54 patients had clinical follow-up and repeated tests every 4 months.RESULTS: Fifty-two patients (40%) relapsed during the 2-yr follow-up. A significant correlation was found between relapse and gender (p = 0.030) but not between relapse and age, extent and type of disease, previous surgery, sr therapy. Increased L/M test (p = 0.0001) and decreased serum iron level (p = 0.0057) were associated with clinical relapse. Time-dependent analysis, performed on patients receiving serial evaluation, showed that L/M test alteration was the only variable that could predict a relapse (RR 8.84, 95% confidence interval [CI] 1.41-53.37; p < 0.05).CONCLUSIONS: The L/M test identifies Crohn's disease patients in apparent remission, but with a high risk of clinical relapse, better than clinical and biochemical indices. Different treatment strategies might be suggested for this subgroup of patients. (C) 1999 by Am. Coll. of Gastroenterology.