Analysis Of Therapeutic Effect And The Predictive Factors Of Glucocorticoid Treatment In Patients With Severe Ulcerative Colitis

Purpose: To analyze the predictive factors of response to glucocorticoid therapy in severe ulcerative colitis and explore whether prolonged glucocorticoid treatment time is beneficial for patients with SUC.Method: The data of 118 patients with SUC from Anhui Provincial Hospital from January 2006 to December 2017 were collected.,including their general information,laboratory indicators before and after treatment,colonoscopy.According to the effect of glucocorticoid treatment on the 7th day,they were divided into complete remission group,partial remission group and ineffective group.The general conditions,laboratory results and clinical outcome among the groups were compared to analyze the predictors of glucocorticoid efficacy in patients with SUC.According to the treatment outcome on the 14 thday,the patients who had extend the treatment time were divided into remission group(group A)and intractable group(group B).The laboratory examination indexes between the two groups were compared to speculate the reason of relief.Result: 88 patients with SUC were treated with glucocorticoid and evaluated on the7 th day of treatment.The complete remission group,partial remission group,and ineffective group accounted for 22.7%,48.9%,and 28.4%,respectively.Compared the complete remission group with the partial remission group,these indexes achieved the difference statistically significant(P <0.05),including the nutritional status(BMI)before treatment,the frequency of defecations on admission was more than 10 times,the frequency of defecations on the third day more than 6 times after hormone therapy,and the percentage of patients with special infection before treatment.In addition to the above four points,compared the complete remission group with the ineffective group,these indexes achieved the difference statistically significant(P <0.05),including the number of defecations on the first day of treatment,the percentage of patients with significant bloody stool on the third day of treatment,the extent of lesion involvement,platelet,erythrocyte sedimentation rate,albumin,C before treatment,C-reactive protein/albumin.There was a significant difference between the ineffective group and the partial remission group in the ratio of C-reactive protein and C-reactive protein on third day.2.Compared with the complete remission group,the proportion of endoscopic features in the partial remission group and the ineffective group was significantly increased,and the percentage of patients with extensive mucosal injury was statistically significant(P<0.05).3.For patients with incomplete remission,reassessment was made when hormone therapy was extended to 14 days,and new remission group(group A)and still no remission group(group B)accounted for 26.5% and 73.5%,respectively..There was a statistically significant difference in the ratio of erythrocyte sedimentation rate,C-reactive protein and C-reactive protein between the two groups(P<0.05).Conclusion: ESR at admission and the number of diarrhea on the third day of treatment may be an independent predictor of glucocorticoid efficacy.On the 7th day of hormone therapy,the complete remission rate was 22.7%;some patients extended the time to 14 days,and the complete remission rate was 43.2%.Compared with patients who had not remission,the inflammation index improved.