Rutka Mariann, Milassin Ágnes, Szepes Zoltán, SzŰcs Mónika, Nyári Tibor, Bálint Anita, Bor Renáta, Molnár Tamás, Farkas Klaudia
First Department of Medicine, University of Szeged , Szeged , Hungary.
Scand J Gastroenterol. 2015 Aug;50(8):985-90. doi: 10.3109/00365521.2015.1018313. Epub 2015 Mar 2.
The most important goals of the recent therapies of ulcerative colitis (UC) are to induce and maintain clinical remission and to achieve mucosal healing (MH). Rate of endoscopic remission has been shown to be higher than that of clinical remission in large trials like ULTRA and PURSUIT. The aim of our study was to evaluate the correlation between clinical and endoscopic disease activities of UC defined by activity scores.
Clinical and endoscopic activities were evaluated in 100 consecutive UC patients. Clinical activities were defined by two activity indices: the Rachmilewitz Activity Index (CAI) and the partial Mayo score. Colonoscopies and patient enrollments were performed by two experienced gastroenterologists and endoscopists. They graded the findings both according to the endoscopic part of the Rachmilewitz Endoscopic Activity Index (EI) and the Mayo endoscopic subscore. MH was defined as Mayo endoscopic subscore and EI of 0. Histological activity was scored by Riley score.
Clinical and endoscopic activities showed strong correlations using both scoring systems (p = 0.0029 and p = 0.0001). Endoscopic disease activity also correlated with the histological activity (p ≥ 0.001). Significant correlation was shown between the clinical activity and MH (p = 0.0012 and p ≥ 0.001). No association was showed with the extension of the disease and clinical or endoscopic activity.
Assessment of MH is very important for guiding therapy and for evaluation of remission in patients with UC. Our result showed good correlation between the clinical, endoscopic, and histological activities of UC focusing on the importance of evaluating the endoscopic activity of the patients.
溃疡性结肠炎（UC）近期治疗的最重要目标是诱导并维持临床缓解以及实现黏膜愈合（MH）。在诸如ULTRA和PURSUIT等大型试验中，内镜缓解率已被证明高于临床缓解率。我们研究的目的是评估由活动评分定义的UC临床和内镜疾病活动之间的相关性。
对100例连续的UC患者进行临床和内镜活动评估。临床活动由两个活动指数定义：拉赫米列维茨活动指数（CAI）和部分梅奥评分。结肠镜检查和患者入组由两位经验丰富的胃肠病学家和内镜医师进行。他们根据拉赫米列维茨内镜活动指数（EI）的内镜部分和梅奥内镜子评分对检查结果进行分级。MH定义为梅奥内镜子评分和EI均为0。组织学活动通过莱利评分进行评估。
使用两种评分系统时，临床和内镜活动均显示出强相关性（p = 0.0029和p = 0.0001）。内镜疾病活动也与组织学活动相关（p≥0.001）。临床活动与MH之间显示出显著相关性（p = 0.0012和p≥0.001）。未显示疾病范围与临床或内镜活动之间存在关联。
评估MH对于指导UC患者的治疗和缓解评估非常重要。我们的结果显示UC的临床、内镜和组织学活动之间具有良好的相关性，强调了评估患者内镜活动的重要性。
