Department of Pathology, SGRR Institute of Medical & Health Sciences, Patel Nagar, Dehradun, India.
Saudi J Gastroenterol. 2011 May-Jun;17(3):194-8. doi: 10.4103/1319-3767.80383.
BACKGROUND/AIM: Ulcerative colitis is a chronic inflammatory disease of unknown etiology characterized by periods of remission and relapses. This study has been carried out in a group of North Indian patients, where the disease has shown an increasing prevalence and frequent relapses. Hence, there is a need to predict relapse for better management and to reduce morbidity. To assess the importance of biological and histological parameters in predicting relapse when the disease is in quiescent phase.
A prospective study of twenty-six patients with quiescent ulcerative colitis was carried out in Dayanand Medical College and Hospital,Punjab. Only patients with clinical and endoscopic remission at the time of screening visit were included. Hemoglobin, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and serum Interleukin-6 (IL-6) levels were measured. The baseline colonoscopic mucosal biopsies were retrieved and studied. Follow-up was conducted for one year at monthly interval or earlier if relapse occurred.
Fifteen out of twenty-six patients (57.69%) had evidence of clinical relapse during the follow-up. Hemoglobin, ESR, CRP and IL-6 levels were not found to be significant predictors of relapse. Increased number of eosinophils and neutrophils in the lamina propria were observed to be associated with significantly higher relapse rate.
A higher risk of relapse in patients with quiescent colitis can be predicted by the presence of increased number of eosinophils and neutrophils in the lamina propria.
背景/目的：溃疡性结肠炎是一种病因不明的慢性炎症性疾病，其特征为缓解期和复发期。本研究在一群印度北部患者中进行，这些患者的疾病发病率不断上升且频繁复发。因此，有必要预测复发，以便更好地进行管理并降低发病率。评估在疾病处于缓解期时，生物学和组织学参数在预测复发方面的重要性。
在旁遮普邦的 Dayanand 医学院和医院对 26 例处于缓解期的溃疡性结肠炎患者进行了前瞻性研究。仅纳入在筛选就诊时具有临床和内镜缓解的患者。测量血红蛋白、红细胞沉降率（ESR）、C 反应蛋白（CRP）和血清白细胞介素 6（IL-6）水平。获取基线结肠镜黏膜活检并进行研究。在随访期间，每月或出现复发时进行一次随访，为期一年。
在随访期间，26 例患者中有 15 例（57.69%）出现临床复发的证据。血红蛋白、ESR、CRP 和 IL-6 水平均未发现是复发的显著预测因子。固有层中嗜酸性粒细胞和中性粒细胞数量增加与复发率显著升高相关。
固有层中嗜酸性粒细胞和中性粒细胞数量增加可预测处于缓解期的结肠炎患者的复发风险较高。
