Ulcerative colitis endoscopic index of severity is associated with long-term prognosis in ulcerative colitis patients treated with infliximab
Ulcerative colitis endoscopic index of severity is associated with long-term prognosis in ulcerative colitis patients treated with infliximab
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DOI：
10.1111/den.12655
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发表时间：
2016-09-01
影响因子：
5.3
通讯作者：
Kanai, Takanori
中科院分区：
文献类型：
--
作者：
Saigusa, Keiichiro;Matsuoka, Katsuyoshi;Kanai, Takanori
背景和目的：溃疡性结肠炎（UC）是一种慢性炎症性肠病，其特征是缓解期和复发期。粘膜愈合是 UC 的一个新兴治疗目标，并且已经使用了各种评分系统。 UC 内镜严重程度指数 (UCEIS) 是目前唯一经过验证的内镜指数，观察者之间的差异最小。治疗后 UCEIS 评分与 UC 临床结果的相关性尚未得到检验。在本研究中，我们旨在评估英夫利昔单抗治疗后 UCEIS 的有效性。方法：对 2010 年 10 月至 2013 年 7 月期间在庆应义塾大学医院接受英夫利昔单抗治疗的 82 名 UC 患者的病历进行回顾性分析。根据 UCEIS 评估内窥镜检查结果。结果：治疗前平均 UCEIS 评分为 5.1。治疗前 UCEIS 评分与短期结果无关。 45 名患者在开始治疗后 3-12 个月接受了结肠镜检查；治疗后UCEIS平均评分为2.4，其中16名患者（35.6%）为0-1分，19名患者（42.2%）为2-4分，10名患者（22.2%）为5-8分。重要的是，治疗后 UCEIS 评分为 0 或 1 与良好的长期结果相关。 结论：UCEIS 评分是评估接受英夫利昔单抗治疗的 UC 患者内镜改善情况的有用工具，粘膜愈合可以用 UCEIS 评分为 0 或 1 来定义。
Background and Aim: Ulcerative colitis (UC) is a chronic inflammatory bowel disease that is characterized by periods of remission and episodes of relapse. Mucosal healing is an emerging therapeutic target in UC and various scoring systems have been used. The UC endoscopic index of severity (UCEIS) is the only validated endoscopic index at present, with minimum interobserver variation. Correlation of UCEIS scores after treatment and clinical outcomes of UC has not been examined. In the present study, we aimed to evaluate the usefulness of UCEIS after treatment with infliximab.Methods: The medical records of 82 UC patients, treated with infliximab at Keio University Hospital between October 2010 and July 2013, were reviewed retrospectively. Endoscopic findings were evaluated based on the UCEIS.Results: Mean pre-therapeutic UCEIS score was 5.1. Pre-therapeutic UCEIS scores were not associated with short-term-outcomes. Forty-five patients underwent colonoscopy at 3-12 months after starting treatment; mean post-therapeutic UCEIS score was 2.4, with a score of 0-1 in 16 (35.6%) patients, 2-4 in 19 (42.2%) patients, and 5-8 in 10 (22.2%) patients. Importantly, a post-therapeutic UCEIS score of 0 or 1 after treatment was associated with a favorable long-term outcome.Conclusion: UCEIS score is a useful instrument for evaluating endoscopic improvement in UC patients treated with infliximab, and mucosal healing may be defined with a UCEIS score of 0 or 1.