左侧结肠炎和广泛性结肠炎在急性重症结肠炎首次发作后的结肠切除术发生率相似：一项长期随访研究。
Left-sided colitis and extensive colitis have similar colectomy rates after index episode of acute severe colitis: A long-term follow-up study.
作者信息
Jain Saransh, Kedia Saurabh, Bopanna Sawan, Yadav Dawesh P, Goyal Sandeep, Sahni Peush, Dash Nihar R, Pal Sujoy, Makharia Govind, Ahuja Vineet
机构信息
Department of Gastroenterology All India Institute of Medical Sciences New Delhi India.
Department of Gastrointestinal Surgery All India Institute of Medical Sciences New Delhi India.
出版信息
JGH Open. 2017 Nov 28;1(4):134-139. doi: 10.1002/jgh3.12023. eCollection 2017 Dec.
BACKGROUND AND AIM
The extent of disease of ulcerative colitis (UC) has been found to be a predictor of acute severe colitis (ASC), but it is unclear whether the extent of disease at the index episode of ASC is a predictor of long-term outcome.
METHODS
Hospitalized patients satisfying Truelove and Witts' criteria under follow-up at a single center from January 2003 to December 2016 were included. The extent of disease at index ASC was classified according to the Montreal classification as left-sided or extensive colitis. Extent was used to predict the long-term risk of colectomy or steroid dependence following an index episode of ASC.
RESULTS
Of 2076 patients with ulcerative colitis, 241 (12%) had an index episode of ASC. In total, 34 (14%) patients underwent a colectomy at index admission and 53 (26%) over a median follow-up of 48(1-172) months. Left-sided colitis and extensive colitis did not differ in the rate of colectomy at index admission (12% 15%, = 0.4) and colectomy in follow-up (31% 23%, = 0.17). Readmission due to ASC was also similar between the two groups (28% 32%, = 0.6).
CONCLUSION
Extent of disease at index ASC does not predict colectomy at admission and over the long term.
背景与目的
已发现溃疡性结肠炎（UC）的病变范围是急性重症结肠炎（ASC）的一个预测指标，但尚不清楚ASC首次发作时的病变范围是否为长期预后的预测指标。
方法
纳入2003年1月至2016年12月在单一中心接受随访且符合 Truelove和Witts标准的住院患者。根据蒙特利尔分类法将首次发作ASC时的病变范围分为左侧结肠炎或广泛性结肠炎。病变范围用于预测首次发作ASC后结肠切除术或激素依赖的长期风险。
结果
在2076例溃疡性结肠炎患者中，241例（12%）有首次发作的ASC。总共有34例（14%）患者在首次入院时接受了结肠切除术，在中位随访48（1 - 172）个月期间有53例（26%）接受了结肠切除术。左侧结肠炎和广泛性结肠炎在首次入院时的结肠切除率（12%对15%，P = 0.4）以及随访中的结肠切除率（31%对23%，P = 0.17）方面无差异。两组因ASC再次入院的情况也相似（28%对32%，P = 0.6）。
结论
首次发作ASC时的病变范围不能预测入院时及长期的结肠切除术。
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