Song Z, Dong H, Ma N, Ren Y, Jiang B
Department of Gastroenterology, Yulin First Hospital, Yulin 719000, China.
Department of Gastroenterology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing 102218, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2023 Jul 20;43(7):1204-1213. doi: 10.12122/j.issn.1673-4254.2023.07.17.
To assess the value of Improved Mayo Endoscopic Score (IMES) for evaluation of treatment efficacy for active ulcerative colitis (UC).
We retrospectively analyzed the clinical and endoscopic data of 103 patients diagnosed with active UC in Beijing Tsinghua Changgung Hospital from January, 2015 to December, 2020. The severity of endoscopic lesions was determined by Mayo Endoscopic Score and the Ulcerative Colitis Endoscopic Index of Severity (UCEIS), and the area of the endoscopic lesions was evaluated based on the Montreal classification system. The IMES was established by combining the MES with the Montreal classification.
Univariate analysis suggested that young patients (<40 years old), patients with extensive disease type (E3), patients with high endoscopic scores (MES=3, UCEIS>4, and IMES>4), and patients receiving advanced drug therapy (with systemic hormones, immunosuppressants, immunomodulators, and biological agents, etc.) had lower clinical and endoscopic remission rates. COX survival analysis showed that IMES≤4 was an independent risk factor for clinical and endoscopic remission. ROC curve indicated that the predictive value of IMSE≤4 for clinical and endoscopic remission (AUC=0.7793 and 0.7095, respectively; <0.01) was better than that of Montreal (AUC=0.7357 and 0.6847, respectively; <0.01), MES=2 (AUC=0.6671 and 0.5929, respectively; <0.01), and UCEIS≤4 (AUC=0.6823 and 0.6459, respectively; <0.01); IMES=5 had a better predictive value for patients with active UC undergoing colectomy tham E3 and MES=3.
IMES has good value in evaluating treatment efficacy for active UC.
评估改良梅奥内镜评分（IMES）在评价活动期溃疡性结肠炎（UC）治疗疗效中的价值。
回顾性分析2015年1月至2020年12月在北京清华长庚医院确诊为活动期UC的103例患者的临床和内镜数据。内镜病变的严重程度通过梅奥内镜评分和溃疡性结肠炎内镜严重指数（UCEIS）确定，内镜病变面积根据蒙特利尔分类系统进行评估。IMES是通过将MES与蒙特利尔分类相结合而建立的。
单因素分析表明，年轻患者（<40岁）、病变范围广泛型（E3）患者、内镜评分高（MES=3、UCEIS>4和IMES>4）的患者以及接受高级药物治疗（使用全身激素、免疫抑制剂、免疫调节剂和生物制剂等）的患者临床和内镜缓解率较低。COX生存分析表明，IMES≤4是临床和内镜缓解的独立危险因素。ROC曲线表明，IMSE≤4对临床和内镜缓解的预测价值（AUC分别为0.7793和0.7095；<0.01）优于蒙特利尔分类（AUC分别为0.7357和0.6847；<0.01）、MES=2（AUC分别为0.6671和0.5929；<0.01）以及UCEIS≤4（AUC分别为0.6823和0.6459；<0.01）；对于接受结肠切除术的活动期UC患者，IMES=5比E3和MES=3具有更好的预测价值。
IMES在评估活动期UC的治疗疗效方面具有良好价值。
