臨床的寛解期に内視鏡検査を施行された潰瘍性大腸炎患者を対象とし, 内視鏡的な活動性が長期予後に影響を及ぼすか否か検討を行った。内視鏡スコアと再燃率に有意な相関を認めた。再燃率に関与する因子として, 多変量解析では内視鏡的活動性, 寛解維持期間, 白血球除去療法による寛解導入治療, 組織学的活動性の項目において有意差を認めた。今回の結果により, 内視鏡的活動性が臨床的再燃の予測因子であることが示された。
We explored the association of a variety of factors including endoscopic activity of patients in clinical remission with their long-term clinical outcome. Mayo endoscopic score 1 (hazard ratio (HR) : 2.86) and score 2 (HR : 3.60) was significant risk factor for clinical relapse against endoscopic score 0. Univariate analysis also identified significant association with relapse for moderate clinical activity of last flare, remission induction with cytapheresis (CAP), maintenance with imuunomodulator, shorter duration of remission and higher histological activity. Cox regression analysis revealed that endoscopic activity, histological activity, duration of remission and remission induction with CAP were found to be independent determinants of relapse. The Kaplan-Meier estimate of non-relapse rate by endoscopic activity groups demonstrated significant difference. While there was significance between score 0 and 1, there were no significance between score 1 and 2.
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