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1Steroid-sparing strategies in the management of ulcerative colitis:Efficacy of leukocytapheresis显示文摘Active ulcerative colitis (UC) is frequently associated with infiltration of a large number of leukocytes into the bowel mucosa. Leukocytapheresis is a novel nonphar- macologic approach for active UC, in which leukocytes are mechanically removed from the circulatory system. Current data indicate that leukocytapheresis is effica- cious in improving response and remission rates with excellent tolerability and safety in patients with UC. Corticosteroid therapy remains a mainstay in the treat- ment of active UC; however, long-term, high doses of corticosteroids usually produce predictable and po- tentially serious side effects. If leukocytapheresis can spare patients from exposure to corticosteroids, the risk of steroid-induced adverse events should be mini- mized. This may be of great benefit to patients because severe side effects of steroids seriously impair health- related quality of life. In this article, we reviewed cur- rent evidence on whether leukocytapheresis can avoid or reduce the use of corticosteroids in the manage- ment of patients with UC. Several studies have shown that leukocytapheresis was effective for steroid-na ve patients with active UC. Furthermore, both short-term and long-term studies have demonstrated the steroid- sparing effects of leukocytapheresis therapy in patients with UC. Although the evidence level is not striking, the available data suggest that leukocytapheresis can avoid or reduce the use of corticosteroids in the management of UC. Large, well-designed clinical trials are necessary to more accurately evaluate the steroid-sparing effects of leukocytapheresis in the management of UC.Manabu Shiraki Takayuki Yamamoto 2012World Journal of Gastroenterology2012,18,41:3
2嗜酸性粒细胞在溃疡性结肠炎患者中的临床及病理学意义显示文摘目的:探讨嗜酸性粒细胞(EG)与评判溃疡性结肠炎(UC)病情的其他指标的一致性,病理组织学特征与EG的关系.方法:选取2007-11/2008-12就诊于湘雅二医院并诊断为UC患者45例,将患者分为:活动组(n=45)与好转组(n=39,在治疗6wk到最后1d,经DAI、EAI及组织病理学评分,完全缓解和部分缓解的患者).采用CAI积分、EAI积分及组织病理学积分评价疾病活动度,并进行EG计数.结果:UC患者结肠黏膜组织中的炎症细胞浸润以中性粒细胞、淋巴细胞、浆细胞以及EG为主,活动组较好转组为重.固有层小血管病变和腺体病变以及隐窝脓肿的出现均以活动组为重.间质改变好转组较多.EG计数与中性粒细胞计数在好转组呈负相关(r=0.568,P=0.001).EG浸润的出现在活动组与淋巴组织增生、淋巴滤泡形成呈正相关(r=0.755,0.524,均P<0.01),与灶性出血呈负相关(r=-0.385,P=0.010).而好转组患者中,仅有杯状细胞消失与EG浸润呈正相关(r=0.349,P=0.046).结论:EG可能为判断UC活动或好转的指标.崔熠 张洁 李学锋 陈琳琳 赵鑫 卢放根 2009世界华人消化杂志2009,17,30:0
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