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单因素分析以检查溃疡性结肠炎患者对白细胞去除术反应的预测因素。

Univariate analysis to examine predictors of response to leukocytapheresis in ulcerative colitis patients.

作者信息

Nagayama Koji, Takedatsu Hidetoshi, Mitsuyama Keiichi, Yamasaki Hiroshi, Kuwaki Kotaro, Yoshioka Shinichiro, Kobayashi Teppei, Yamauchi Ryosuke, Kakuma Tatsuyuki, Sata Michio

机构信息

Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan.

出版信息

Ther Apher Dial. 2014 Jun;18(3):244-51. doi: 10.1111/1744-9987.12211.

Abstract

Leukocytapheresis (LCAP) is reportedly effective for the treatment of active ulcerative colitis (UC) and is a therapeutic option for steroid-dependent or steroid-resistant patients with UC. However, a consensus regarding the use of LCAP for UC patients has not yet been established. Therefore, we analyzed patients' records to identify predictors of response to LCAP therapy and subsequent recurrence. Between October 2001 and March 2011, we recruited 41 patients who had been diagnosed as having UC and had received LCAP therapy. Patients diagnosed with moderate to severe UC with left-side or total colitis and received LCAP therapy for the first time were enrolled. We retrospectively performed a univariate analysis using the patients' medical records to identify factors affecting the therapeutic effect of LCAP. Body mass index exceeding 18.5 kg/m(2) was found to influence the therapeutic effect of LCAP. Male sex was correlated with a rapid response to LCAP treatment and the maintenance of remission. UC patients experiencing their first attack or had an elevated C-reactive protein level prior to LCAP therapy exhibited a relatively long remission period. In the "after LCAP therapy" group, a low Rachmilewitz endoscopic score, low erythrocyte sedimentation rate, or high white blood cell count was associated with a long remission period. Our results suggest that LCAP should be performed for the treatment of early-onset UC. LCAP can be expected to induce a long remission period, enabling mucosal healing, although the factors that affected the remission period did not influence the therapeutic effect and responsiveness.

摘要

据报道,白细胞去除术(LCAP)对活动性溃疡性结肠炎(UC)的治疗有效,是UC激素依赖或激素抵抗患者的一种治疗选择。然而,关于UC患者使用LCAP的共识尚未确立。因此,我们分析了患者记录,以确定对LCAP治疗反应及随后复发的预测因素。在2001年10月至2011年3月期间,我们招募了41例被诊断为UC并接受了LCAP治疗的患者。纳入首次接受LCAP治疗、被诊断为中度至重度左侧或全结肠炎的UC患者。我们回顾性地利用患者病历进行单因素分析,以确定影响LCAP治疗效果的因素。发现体重指数超过18.5kg/m²会影响LCAP的治疗效果。男性与对LCAP治疗的快速反应及缓解的维持相关。首次发作或在LCAP治疗前C反应蛋白水平升高的UC患者缓解期相对较长。在“LCAP治疗后”组中,低Rachmilewitz内镜评分、低红细胞沉降率或高白细胞计数与较长的缓解期相关。我们的结果表明,LCAP应用于早发性UC的治疗。尽管影响缓解期的因素未影响治疗效果和反应性,但预计LCAP可诱导较长的缓解期,实现黏膜愈合。

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