Therapeutic Effects Of Glucocorticoids For Severe Ulcerative Colitis And Analysis Of Correlation Factors

Objective: To analyze the therapeutic effects of glucocorticoids(GCs)for severe ulcerative colitis(SUC),and the influencing factors for treatment response.Methods: Retrospective analysis was performed on clinical data,including general characteristics,clinical manifestations,serology,endoscopic findings,therapeutic approach and outcome,etc.,of 46 patients with SUC treated with GCs in Department of Gastroenterology,Shengjing Hospital of China Medical University from January 2013 to June 2017.Depending on the treatment response to GCs,patients were assigned to the response group(n=34)or non-response group(n=12)to analyze the potential influencing factors for the treatment response to GCs.Results: The lesions involved the total colon in the majority of the patients(93.47%),and the response rate to GCs for the control of acute exacerbation of SUC was 73.91%.There were no statistically significant differences between the two groups in age,sex,disease duration,length of hospital stay,previous use of corticoids,hemoglobin<90g/L,ESR>75mm/h,or CRP>45mg/L(P>0.05).There were statistically significant differences between the two groups in frequency of diarrhea at admission≥10 times/day,previous history of severe exacerbation,body temperature at admission>38℃,bloody stools remaining 3 days into treatment,albumin < 30 g/L and platelets>300X10^9/L(P<0.05).Conclusion: SUC is a life-threatening disease characterized by older age at onset and typical involvement of total colon.For patients with SUC,frequency of diarrhea at admission≥10 times/day,previous history of severe exacerbation,body temperature at admission>38℃,bloody stools remaining 3 days into treatment,albumin < 30 g/Land platelets>300X10^9/L might be predictive of worse treatment response to GCs.