Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Second Department of Internal Medicine, Wakayama Medical University, Wakayama, Japan.
Gut Liver. 2018 Jul 15;12(4):420-425. doi: 10.5009/gnl17236.
BACKGROUND/AIMS: Although mucosal healing (MH) has been considered a treatment goal for patients with ulcerative colitis (UC), the risk factors predictive of relapse in patients who achieve MH are unknown. Because the platelet count has been shown to be a marker of inflammation in inflammatory bowel diseases, this study aimed to assess whether the platelet count could predict relapse in UC patients with MH.
A prospective observational study was performed. UC patients with MH were consecutively enrolled in the study and monitored for at least 2 years or until relapse. The correlation between the incidence of relapse and the platelet count at the time of study enrollment was examined.
In total, 43 patients were enrolled, and 14 patients (33%) relapsed. The median platelet count at the time of enrollment in the patients who relapsed significantly differed from that in the patients who did not relapse (27.2×10⁴/μL vs 23.8×10⁴/μL, respectively; p=0.016). A platelet count ＞25.0×10⁴/μL was a significant risk factor for relapse based on a multivariate analysis (hazard ratio, 4.85; 95% confidence interval, 1.07 to 25.28), and according to the Kaplan-Meier analysis, this cutoff could identify patients susceptible to relapse (p=0.041, log-rank test).
The platelet count could be used as a predictor of relapse in UC patients with MH.
背景/目的：虽然黏膜愈合（MH）已被认为是溃疡性结肠炎（UC）患者的治疗目标，但对于达到 MH 的患者，预测其复发的风险因素尚不清楚。由于血小板计数已被证明是炎症性肠病的炎症标志物，因此本研究旨在评估血小板计数是否可以预测 MH 的 UC 患者的复发。
进行了一项前瞻性观察性研究。连续招募 MH 的 UC 患者，并对其进行至少 2 年的监测，或直至复发。检查研究入组时的血小板计数与复发发生率之间的相关性。
共纳入 43 例患者，其中 14 例（33%）患者复发。复发患者的血小板计数中位数明显高于未复发患者（27.2×10⁴/μL 比 23.8×10⁴/μL，p=0.016）。根据多变量分析，血小板计数＞25.0×10⁴/μL 是复发的显著危险因素（危险比，4.85；95%置信区间，1.07 至 25.28），根据 Kaplan-Meier 分析，该截值可以识别易复发的患者（p=0.041，对数秩检验）。
血小板计数可作为 MH 的 UC 患者复发的预测指标。
