Department of Clinical Sciences, Gastrointestinal Unit, Policlinico Umberto I, University of Rome, La Sapienza, Viale del Policlinico 155, Rome 00161, Italy. Italy.
World J Gastroenterol. 2011 Apr 14;17(14):1831-5. doi: 10.3748/wjg.v17.i14.1831.
To identify factors predicting the clinical response of ulcerative colitis patients to granulocyte-monocyte apheresis (GMA).
Sixty-nine ulcerative colitis patients (39 F, 30 M) dependent upon/refractory to steroids were treated with GMA. Steroid dependency, clinical activity index (CAI), C reactive protein (CRP) level, erythrocyte sedimentation rate (ESR), values at baseline, use of immunosuppressant, duration of disease, and age and extent of disease were considered for statistical analysis as predictive factors of clinical response. Univariate and multivariate logistic regression models were used.
In the univariate analysis, CAI (P = 0.039) and ESR (P = 0.017) levels at baseline were singled out as predictive of clinical remission. In the multivariate analysis steroid dependency [Odds ratio (OR) = 0.390, 95% Confidence interval (CI): 0.176-0.865, Wald 5.361, P = 0.0160] and low CAI levels at baseline (4 < CAI < 7) (OR = 0.770, 95% CI: 0.425-1.394, Wald 3.747, P = 0.028) proved to be effective as factors predicting clinical response.
GMA may be a valid therapeutic option for steroid-dependent ulcerative colitis patients with mild-moderate disease and its clinical efficacy seems to persist for 12 mo.
确定预测溃疡性结肠炎患者对粒细胞-单核细胞吸附（GMA）临床反应的因素。
69 例依赖/难治于类固醇的溃疡性结肠炎患者（39 例女性，30 例男性）接受 GMA 治疗。将类固醇依赖性、临床活动指数（CAI）、C 反应蛋白（CRP）水平、红细胞沉降率（ESR）、基线值、免疫抑制剂的使用、疾病持续时间以及年龄和疾病范围作为预测临床反应的统计分析的预测因素。使用单变量和多变量逻辑回归模型。
在单变量分析中，基线时的 CAI（P = 0.039）和 ESR（P = 0.017）水平被单独确定为临床缓解的预测因素。在多变量分析中，类固醇依赖性[比值比（OR）= 0.390，95%置信区间（CI）：0.176-0.865，Wald 5.361，P = 0.0160]和基线时低 CAI 水平（4 < CAI < 7）（OR = 0.770，95% CI：0.425-1.394，Wald 3.747，P = 0.028）被证明是预测临床反应的有效因素。
GMA 可能是治疗轻度-中度疾病的类固醇依赖性溃疡性结肠炎患者的有效治疗选择，其临床疗效似乎可持续 12 个月。
