Kim Eun Soo, Kim Kyeong Ok, Jang Byung Ik, Kim Eun Young, Lee Yoo Jin, Lee Hyun Seok, Jeon Seong Woo, Kim Hyun Jin, Kim Sung Kook
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyungpook National University School of Medicine, 130 Dongdeok-ro, Jung-gu, Daegu, 700-721, Korea.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea.
Dig Dis Sci. 2017 Sep;62(9):2489-2497. doi: 10.1007/s10620-017-4634-7. Epub 2017 Jun 21.
Although colonoscopy preparation may cause symptom flares in patients with ulcerative colitis (UC), little is known about the standard preparation regimen in this population.
We aimed to compare 4L polyethylene glycol (4L-PEG) with 2L polyethylene glycol plus ascorbic acid (2L-PEG-Asc) in quiescent UC patients.
Patients with inactive UC undergoing colonoscopy for surveillance or checkup of mucosal healing were prospectively enrolled at 5 tertiary hospitals. They were randomly assigned to 4L-PEG and 2L-PEG-Asc groups. The Boston Bowel Preparation Scale (BBPS) was used for the preparation quality. Symptoms were assessed using the Simple Clinical Colitis Activity Index (SCCAI) before colonoscopy, at 1 and 4 weeks after the procedure.
Overall, 109 patients were included in the study (4L-PEG group 53, 2L-PEG-Asc group 56, the mean age at diagnosis 42.25 years, male 77). The quality of preparation was comparable between the groups (BBPS ≥ 6, 96.2 vs. 92.9%, p = 0.679). Although 26 patients (23.8%) had increased SCCAI scores within 4 weeks after colonoscopy, resulting in a medication dose-up or add-on in 3 patients (2.7%), the rise in scores was not different between the groups. No serious adverse events during preparation were observed in either group. However, the 2L-PEG-Asc group was more likely to be willing to repeat the preparation with the same agent than the 4L-PEG group (82.1 vs. 64.2%, respectively, p = 0.034).
PEG-based regimens with different volumes are equally effective and safe in inactive UC patients. 2L-PEG-Asc is more acceptable in this population as indicated by the willingness for further usage.
尽管结肠镜检查前的肠道准备可能会导致溃疡性结肠炎（UC）患者症状复发，但对于该人群的标准准备方案知之甚少。
我们旨在比较4升聚乙二醇（4L-PEG）与2升聚乙二醇加抗坏血酸（2L-PEG-Asc）在静止期UC患者中的效果。
在5家三级医院前瞻性纳入因监测或检查黏膜愈合而接受结肠镜检查的静止期UC患者。他们被随机分配到4L-PEG组和2L-PEG-Asc组。使用波士顿肠道准备量表（BBPS）评估准备质量。在结肠镜检查前、检查后1周和4周，使用简单临床结肠炎活动指数（SCCAI）评估症状。
总体而言，109例患者纳入研究（4L-PEG组53例，2L-PEG-Asc组56例，诊断时平均年龄42.25岁，男性77例）。两组之间的准备质量相当（BBPS≥6，分别为96.2%和92.9%，p = 0.679）。尽管26例患者（占23.8%）在结肠镜检查后4周内SCCAI评分升高，导致3例患者（占2.7%）增加药物剂量或加用药物，但两组之间评分升高情况无差异。两组在准备过程中均未观察到严重不良事件。然而，2L-PEG-Asc组比4L-PEG组更愿意使用相同药物重复进行肠道准备（分别为82.1%和64.2%，p = 0.034）。
不同容量的基于聚乙二醇的方案在静止期UC患者中同样有效且安全。如进一步使用的意愿所示，2L-PEG-Asc在该人群中更易被接受。
