Changes in the clinical course and prognosis of ulcerative colitis in Chinese populations: a retrospective cohort study.

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2024-07-01 Epub Date: 2024-05-07 DOI:10.5217/ir.2023.00106

Xinyu Liu, Qingfan Yang, Na Diao, Jian Tang, Zicheng Huang, Xiang Gao, Kang Chao

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引用次数: 0

Abstract

Background/aims: Data on the natural course of Chinese patients with ulcerative colitis (UC) was lacking. This study aimed to evaluate the natural history and prognosis of patients with UC in the past 15 years in China.

Methods: This cohort study included patients with UC in a tertiary hospital in southern China from 2007 to 2021 (cohort I: 2007-2011, cohort II: 2012-2016, cohort III: 2017-2021). Patients' clinical characteristics and natural history were analyzed retrospectively.

Results: Of 1,139 included patients, 683 patients presented with proctitis or left-sided colitis at diagnosis and 38.5% of them (263/683) developed proximal disease extension. Fifty-eight percent of patients experienced relapse, chronic continuous and intermittent active course. Five patients (0.4%) developed colorectal tumors/dysplasia. The overall surgery rate was 8.6%, and the rates were 14.2%, 7.8%, and 8.0% in the 3 cohorts, respectively (P= 0.059). Average time from diagnosis to surgery decreased from cohorts I to III (144 months vs. 36 months, P< 0.001), so did the use of glucocorticoids (58.2% vs. 43.5%, P< 0.001) and immunosuppressants (14.1% vs. 13.4%, P= 0.016), and days of hospitalization (13 days vs. 9 days, P< 0.001). Biologics were used more frequently during the first year (0.8%, 2.1%, and 13.7% for cohorts I to III, respectively; P< 0.001). The rate of mucosal healing increased over time.

Conclusions: In Chinese UC patients, one-third of patients experienced proximal disease extension. The rates of malignancy and mortality were low. More biologics were used, while use of immunosuppressants and glucocorticoids were reduced over time. Early biologics use seemed to promote mucosal healing, but the rate of colectomy has not dramatically decreased.

查看原文本刊更多论文

中国人群溃疡性结肠炎临床过程和预后的变化：一项回顾性队列研究。

背景/目的：有关中国溃疡性结肠炎（UC）患者自然病程的数据十分缺乏。本研究旨在评估过去15年中国溃疡性结肠炎患者的自然病史和预后：这项队列研究纳入了2007年至2021年在中国南方一家三甲医院就诊的UC患者（队列I：2007-2011年；队列II：2012-2016年；队列III：2017-2021年）。对患者的临床特征和自然病史进行回顾性分析：在纳入的1139名患者中，683名患者在确诊时表现为直肠炎或左侧结肠炎，其中38.5%的患者（263/683）出现了近端疾病扩展。58%的患者经历了复发、慢性持续性和间歇性活动期。5名患者（0.4%）出现结直肠肿瘤/增生。总手术率为8.6%，三组患者的手术率分别为14.2%、7.8%和8.0%（P= 0.059）。从诊断到手术的平均时间从第一组到第三组有所缩短（144 个月对 36 个月，P< 0.001），糖皮质激素（58.2% 对 43.5%，P< 0.001）和免疫抑制剂（14.1% 对 13.4%，P= 0.016）的使用率以及住院天数也有所缩短（13 天对 9 天，P< 0.001）。生物制剂在第一年的使用频率更高（第一组至第三组分别为 0.8%、2.1% 和 13.7%；P< 0.001）。随着时间的推移，粘膜愈合率也在增加：结论：在中国的 UC 患者中，三分之一的患者出现了近端疾病扩展。结论：在中国的 UC 患者中，三分之一的患者出现了近端疾病扩展，恶性肿瘤发生率和死亡率较低。随着时间的推移，免疫抑制剂和糖皮质激素的使用逐渐减少。早期生物制剂的使用似乎促进了粘膜愈合，但结肠切除术的比例并未显著下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.