摘要
目的:评估5-氨基水杨酸(5-ASA)对溃疡性结肠炎(UC)缓解期患者维持治疗及影响UC复发的相关因素.方法:回顾性分析2004-01/2010-08在北京大学第一医院消化内科就诊的114例缓解期UC患者的临床资料,纳入分析病例114例.其中,男64例,女50例,年龄16-76岁.结果:选择应用5-ASA诱导缓解治疗病例75例(65.8%).结果显示:(1)UC复发与性别无关;(2)病程>5年的UC患者复发率显著高于病程≤5年的UC患者(62.1%vs35.7%,P>0.05);(3)轻度UC患者5-ASA维持治疗剂量>2g/d者复发率显著低于≤2g/d者(10%vs33.3%,P<0.05);(4)轻度UC患者复发率显著低于中度和重度患者(24.6%vs83.3%,80.6%,P<0.05);(5)直肠型UC患者复发率(19.2%)较低;(6)诱导缓解治疗达到黏膜愈合患者的复发率显著低于未达到黏膜愈合的患者(4.8%vs89.6%,P<0.05);(7)UC患者诱导缓解后第2年始复发率随时间逐年上升.结论:黏膜愈合及疾病活动程度是影响UC复发率的重要因素,5-ASA是轻-中度UC维持缓解治疗的首选药物,5-ASA维持治疗剂量>2g/d、疗程至少2年以上,可有效降低UC的复发率.
AIM：To evaluate the clinical significance of 5-aminosalicylic acid（5-ASA） as a maintenance therapy for patients with ulcerative colitis（UC）.METHODS：The clinical data for 114 UC patients（including 64 males and 50 females,aged from 16 to 76 years old） treated from January 2004 to August 2010 were analyzed retrospectively.RESULTS：Seventy-f ive patients（65.8%） underwent 5-ASA therapy for induction of remission.There was no correlation between sex and the relapse rate of UC.The relapse rate in patients who had a history of more than 5 years was higher than those with a shorter history（62.1% vs 35.7%,P 0.05）.The relapse rate was significantly lower in mild patients undergoing maintenance treatment with 5-ASA more than 2 g daily than in those given 5-ASA less than 2 g daily（10% vs 33.3%,P 0.05）,in patients with mild disease than in those with moderate or severe disease（24.6% vs 83.3%,80.6%,both P 0.05）,in patients with proctitis than in those without proctitis（P 0.05）,and in patients who achieved mucosal healing than in those who did not（4.8% vs 89.6%,P 0.05）.The relapse rate of UC gradually increased from the second year after remission.CONCLUSION：Mucosal healing and disease activity of UC are the most important factors associated with the recurrence of the disease.5-ASA is the first choice for patients with mild and moderate disease.UC patients undergoing maintenance treatment with 5-ASA more than 2 g daily for 2 years can reduce the recurrence of the disease.
出处
《世界华人消化杂志》
CAS
北大核心
2011年第4期416-420,共5页
World Chinese Journal of Digestology
关键词
溃疡性结肠炎
5-氨基水杨酸
维持缓解
Ulcerative colitis
5-aminosalicylic acid
Maintenance remission
