炎症性袋状疾病的类型、行为及治疗需求：GETECCU的RESERVO研究结果

Types, behaviour and therapeutic requirements of inflammatory pouch disorders: Results from the RESERVO study of GETECCU.

作者信息

Mesonero F, Zabana Y, Fernández-Clotet A, Solá A, Caballol B, Leo-Carnerero E, García M J, Bertoletti F, Bastida G, Suris G, Casis B, Ferreiro-Iglesias R, Calafat M, Jiménez I, Miranda-Bautista J, Lamuela L J, Fajardo I, Torrealba L, Nájera R, Sáiz-Chumillas R M, González-Partida I, Vicuña M, García-Morales N, Gutiérrez A, López-García A, Benítez J M, Rubín de Célix C, Tejido C, Brunet E, Hernandez-Camba A, Suárez C, Rodríguez-Lago I, Piqueras M, Castaño A, Ramos L, Sobrino A, Rodríguez-Grau M C, Elosua A, Montoro M, Baltar R, Huguet J M, Hermida B, Caballero-Mateos A, Sánchez-Guillén L, Bouhmidi A, Pajares R, Baston-Rey I, López-Sanromán A, Albillos A, Barreiro-de Acosta M

机构信息

Hospital Universitario Ramón y Cajal (Madrid), Spain; Universidad Alcalá de Henares (Madrid), Spain.

Hospital Universitario Mútua Terrassa (Terrassa), Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Spain.

出版信息

Dig Liver Dis. 2025 Feb;57(2):566-573. doi: 10.1016/j.dld.2024.09.023. Epub 2024 Oct 24.

DOI:10.1016/j.dld.2024.09.023

PMID:39455313

Abstract

BACKGROUND AND AIMS

Inflammatory pouch disorders exhibit a heterogeneous clinical spectrum and therapeutic requirements have not been properly studied.

METHODS

This retrospective, multicentre study included ulcerative colitis patients with ileal pouch construction and were later diagnosed with an inflammatory pouch disorder between 1995 and 2020. Classifications, behaviour and therapies applied were recorded and compared in the long-term.

RESULTS

Overall, 338 patients were recruited. The most common disorders were pouchitis (n = 258, 76%), Crohn's disease of the pouch (n = 55, 16%) and cuffitis (n = 25, 7%). Pouchitis presented mainly as chronic (65.2%) and recurrent (87%) forms. Crohn's disease manifested as stricturing/penetrating in 53% of cases and perianal disease in 42%. Patients received multiple therapies: 86% antibiotics, 42% steroids, 27% immunosuppressants, 43% biologics and 27% surgery. Compared with pouchitis, Crohn's disease of the pouch was characterised by a later diagnosis (99 vs. 55 months, p < 0.001) and greater needs for immunosuppressants (OR 3.53, 1.79-6.94, p < 0.0001), biologics (OR 5.45, 2.78-10.6, p < 0.0001) and surgeries (OR 2.65, 1.43-4.89, p < 0.001).

CONCLUSIONS

Chronic pouchitis is the most common pouch disorder presentation. These entities have diverse therapeutics requirements, particularly for Crohn's disease of the pouch.

摘要

背景与目的

炎症性储袋疾病临床表现多样，其治疗需求尚未得到充分研究。

方法

这项回顾性多中心研究纳入了1995年至2020年间接受回肠储袋构建术且后来被诊断为炎症性储袋疾病的溃疡性结肠炎患者。记录并长期比较所应用的分类、病情及治疗方法。

结果

共招募了338例患者。最常见的疾病是储袋炎（n = 258，76%）、储袋克罗恩病（n = 55，16%）和袖口炎（n = 25，7%）。储袋炎主要表现为慢性（65.2%）和复发性（87%）形式。克罗恩病在53%的病例中表现为狭窄/穿透性，42%表现为肛周疾病。患者接受了多种治疗：86%使用抗生素，42%使用类固醇，27%使用免疫抑制剂，43%使用生物制剂，27%接受手术治疗。与储袋炎相比，储袋克罗恩病的特点是诊断较晚（99个月对55个月，p < 0.001），对免疫抑制剂（OR 3.53，1.79 - 6.94，p < 0.0001）、生物制剂（OR 5.45，2.78 - 10.6，p < 0.0001）和手术（OR 2.65，1.43 - 4.89，p < 0.001）的需求更大。