Department of Clinical Microbiology, Medical Research & Laboratory Diagnostic Center, Jinan Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Jinan, Shandong, China.
Gastroenterology, Jinan Central Hospital Affiliated to Shandong First Medical University, 105 Jiefang Road, Jinan, China.
BMC Gastroenterol. 2020 Nov 26;20(1):401. doi: 10.1186/s12876-020-01548-w.
Ulcerative colitis (UC) is a chronic inflammatory bowel disease (IBD), the pathogenesis of which is complicated, and it is difficult to treat. In recent years, the emerging fecal microbiota transplantation (FMT) has shown good effects in UC treatment and is therefore accepted by increasing numbers of patients. Our hospital has carried out FMT since 2017, and has achieved good results in UC treatment. We have found in our clinical work that the efficacy of re-FMT after recurrence decreased. This is difference from reported literatures. In order to attract clinical attention, here we selected typical cases for analysis.
Among all UC patients who received FMT in our hospital, 12 patients with moderate to severe UC were selected. They all received multiple FMT and were followed up for 52 weeks. Besides, none of them had other underlying diseases. Colonoscopy images of patients were presentated, SCCAI and UCDAI were used assess the effect of FMT.
On the whole, FMT has a significant effect on moderate to severe UC. Of the 12 patients, 11 (91.7%) achieved a clinical response, 9 (75.0%) achieved clinical remission, and only one patient did not respond to FMT treatment. However, 6 patients relapsed within 52 weeks after remission, with a recurrence rate of 54.5%. Four of the six relapsed patients received FMT again, but the efficacy of FMT after relapse was significantly lower than that of the initial FMT. Fortunately, compared to before the initial FMT treatment, the severity of the disease after relapse was significantly reduced.
FMT has a good effect on the relief of moderate to severe UC. However, the effect of FMT treatment after relapse is reduced. For patients who relapse after remission, the efficacy of FMT reapplication requires more experiments to verify.
溃疡性结肠炎（UC）是一种慢性炎症性肠病（IBD），其发病机制复杂，治疗困难。近年来，新兴的粪便微生物群移植（FMT）在 UC 治疗中显示出良好的效果，因此越来越多的患者接受了这种治疗。我院自 2017 年开展 FMT 以来，在 UC 治疗方面取得了良好的效果。我们在临床工作中发现，复发后再次进行 FMT 的疗效降低。这与报道的文献不同。为了引起临床关注，我们在此选择了典型病例进行分析。
在我院接受 FMT 的所有 UC 患者中，选择了 12 例中重度 UC 患者。他们都接受了多次 FMT，并进行了 52 周的随访，且均无其他基础疾病。呈现了患者的结肠镜图像，采用 SCCAI 和 UCDAI 评估 FMT 的效果。
总体而言，FMT 对中重度 UC 有显著效果。在 12 例患者中，11 例（91.7%）获得临床缓解，9 例（75.0%）达到临床缓解，只有 1 例对 FMT 治疗无反应。然而，在缓解后 52 周内，有 6 例患者复发，复发率为 54.5%。6 例复发患者中有 4 例再次接受了 FMT，但复发后 FMT 的疗效明显低于首次 FMT。幸运的是，与首次 FMT 治疗前相比，复发后的疾病严重程度明显降低。
FMT 对缓解中重度 UC 有良好效果。然而，复发后 FMT 治疗的效果降低。对于缓解后复发的患者，再次应用 FMT 的疗效需要更多的实验来验证。
