Gastroenterology Service, ASL BAT, Andria, Barletta, Italy.
Eur Rev Med Pharmacol Sci. 2013 Feb;17(3):342-8.
Colonic diverticulitis shows a high recurrence rate.
To assess the efficacy of three different therapeutic strategies in preventing diverticulitis recurrence.
One hundred thirty patients suffering from Acute Uncomplicated Diverticulitis (AUD) (81 males, 49 females, mean age 64.71 years, range 40-85) were prospectively assessed. After obtaining remission, considered present when both endoscopic and histological damage were absent, the patients were treated with mesalazine 1.6 g/day (59 patients, group A), or rifaximin 800 mg/day for 7 days every month (52 patients, group B). Clinical, endoscopic and histological follow-up was performed after 6, 12 and thereafter every 12 months after diagnosis of AUD.
Seven patients were excluded from final evaluation because they were lost to follow-up. Fifty-five group A patients and 49 group B patients patients were available for the final assessment at the end of a 24-month follow-up. Sustained remission was significantly higher in group A with respect to group B.
Patients taking mesalazine have lower risk of diverticulitis recurrence than patients taking rifaximin because of the lower prevalence of persisting endoscopic and histological inflammation.
结肠憩室炎复发率较高。
评估三种不同治疗策略在预防憩室炎复发方面的疗效。
前瞻性评估了 130 名患有急性单纯性憩室炎(AUD)的患者(81 名男性,49 名女性,平均年龄 64.71 岁,范围 40-85)。在获得缓解后,当内镜和组织学损伤均不存在时被认为是缓解期,然后用美沙拉嗪 1.6g/天(59 例,A 组)或利福昔明 800mg/天治疗,每月连用 7 天(52 例,B 组)。在 AUD 诊断后 6、12 个月及之后每 12 个月进行临床、内镜和组织学随访。
有 7 名患者因失访而被排除在最终评估之外。在 24 个月的随访结束时,有 55 名 A 组患者和 49 名 B 组患者可进行最终评估。与 B 组相比,A 组持续缓解的患者比例显著更高。
服用美沙拉嗪的患者憩室炎复发的风险低于服用利福昔明的患者,因为持续存在内镜和组织学炎症的发生率较低。