■显微镜性结肠炎越来越被认为是慢性腹泻的病因。我们旨在描述疾病相关因素和治疗对显微镜下结肠炎临床结局的作用。
我们回顾性回顾了2010年8月至2016年5月在芝加哥大学和俄勒冈健康科学大学接受治疗的显微镜下结肠炎患者的医疗记录。使用单变量和多变量分析评估患者特征和治疗作为临床结果的预测因子。根据医生评估,临床缓解被定义为没有与显微镜下结肠炎相关的症状,组织学缓解被定义为没有显微镜下结肠炎组织学炎症的证据。
■72例显微镜下结肠炎患者纳入研究(28例淋巴细胞性结肠炎和44例胶原性结肠炎)。非甾体抗炎药,质子泵抑制剂和选择性5-羟色胺再摄取抑制剂在23(31.9%),14(19.4%)和15(20.8%),分别,在诊断的时候。在有足够随访数据的46例患者中,25例(54.3%)患者临床缓解。单因素分析显示,对布地奈德的反应(p=.0002)和达到组织学缓解(p=.0008)与临床缓解相关。在多变量分析中,布地奈德反应(p=.0052)与临床缓解相关(比值比25.00,95%置信区间2.63-238.10)。在接受结肠镜检查的22例患者中,5例患者(22.7%)达到组织学缓解.所有组织学缓解的患者在没有药物治疗的情况下维持临床缓解,而只有2例患者(11.8%)在存在组织学炎症时能够停止药物治疗(p=.0002).
■在目前的显微镜下结肠炎患者队列中,对布地奈德的良好反应与长期临床缓解显著相关,所有达到组织学缓解的患者在没有进一步药物治疗的情况下都能够维持临床缓解。需要更大规模的研究来证实这些发现。
UNASSIGNED: Microscopic colitis has been increasingly recognized as a cause of chronic diarrhoea. We aimed to characterize the role of disease-related factors and treatments on the clinical outcomes of microscopic colitis.
UNASSIGNED: We retrospectively reviewed the medical records of patients with microscopic colitis who were treated at the University of Chicago and Oregon Health & Science University between August 2010 and May 2016. Patient characteristics and treatments were evaluated as predictors of clinical outcomes using univariate and multivariate analyses. Clinical remission was defined as no symptoms associated with microscopic colitis based on physician assessment and histologic remission was defined as no evidence of histological inflammation of microscopic colitis.
UNASSIGNED: Seventy-two patients with microscopic colitis were included in the study (28 with lymphocytic colitis and 44 with collagenous colitis). Non-steroidal anti-inflammatory drugs, proton pump inhibitors and selective serotonin reuptake inhibitors were used in 23 (31.9%), 14 (19.4%) and 15 (20.8%), respectively, at the time of diagnosis. Among 46 patients with adequate follow-up data, 25 (54.3%) patients achieved clinical remission. Response to
budesonide (p = .0002) and achieving histologic remission (p = .0008) were associated with clinical remission on univariate analysis. On multivariate analysis,
budesonide response (p = .0052) was associated with clinical remission (odds ratio 25.00, 95% confidence interval 2.63-238.10). Among 22 patients who underwent a follow-up colonoscopy, five patients (22.7%) achieved histologic remission. All patients with histologic remission maintained clinical remission without medication, whereas only two patients (11.8%) were able to discontinue medical therapy when histologic inflammation was present (p = .0002).
UNASSIGNED: In the present cohort of patients with microscopic colitis, a favourable response to
budesonide was significantly associated with long-term clinical remission, and all patients achieving histological remission were able to maintain clinical remission without further medical therapy. Larger studies are required to confirm these findings.