根据巨细胞病毒抗原状态治疗的溃疡性结肠炎患者的长期随访
Long-term follow-up of ulcerative colitis patients treated on the basis of their cytomegalovirus antigen status.
作者信息
Inokuchi Toshihiro, Kato Jun, Hiraoka Sakiko, Suzuki Hideyuki, Nakarai Asuka, Hirakawa Tomoko, Akita Mitsuhiro, Takahashi Sakuma, Harada Keita, Okada Hiroyuki, Yamamoto Kazuhide
机构信息
Toshihiro Inokuchi, Sakiko Hiraoka, Hideyuki Suzuki, Asuka Nakarai, Tomoko Hirakawa, Mitsuhiro Akita, Sakuma Takahashi, Keita Harada, Hiroyuki Okada, Kazuhide Yamamoto, Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan.
出版信息
World J Gastroenterol. 2014 Jan 14;20(2):509-17. doi: 10.3748/wjg.v20.i2.509.
AIM
To clarify the impact of cytomegalovirus (CMV) activation and antiviral therapy based on CMV antigen status on the long-term clinical course of ulcerative colitis (UC) patients.
METHODS
UC patients with flare-up were divided into CMV-positive and -negative groups according to the CMV antigenemia assay. The main treatment strategy provided for the patients in the CMV-positive group comprised a dose reduction of corticosteroids and administration of ganciclovir.
RESULTS
The median number of days to initial remission was significantly greater for the patients in the CMV-positive group (21 d vs 16 d, P = 0.009). However, the relapse rate after remission and colectomy rate during more than 30 mo of observation did not differ between the two groups. Multivariate analysis revealed that administration of ganciclovir was the only independent factor for avoiding colectomy in patients of the CMV-positive group.
CONCLUSION
CMV antigen status did not significantly affect the long-term prognosis in UC patients under treatment with appropriate antiviral therapy.
目的
阐明巨细胞病毒（CMV）激活及基于CMV抗原状态的抗病毒治疗对溃疡性结肠炎（UC）患者长期临床病程的影响。
方法
将病情发作的UC患者根据CMV抗原血症检测分为CMV阳性组和阴性组。为CMV阳性组患者提供的主要治疗策略包括减少皮质类固醇剂量及给予更昔洛韦。
结果
CMV阳性组患者至初始缓解的中位天数显著更长（21天对16天，P = 0.009）。然而，两组在缓解后的复发率及超过30个月观察期内的结肠切除术率并无差异。多变量分析显示，给予更昔洛韦是CMV阳性组患者避免行结肠切除术的唯一独立因素。
结论
在接受适当抗病毒治疗的UC患者中，CMV抗原状态对长期预后无显著影响。
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