Evaluate the effect of mucosal healing after low-dose azathioprine in patients with small bowel Crohn's disease by double-balloon enteroscopy

Lifen YU; Shidan CHENG; Tianyu ZHANG; Yonghua TANG; Fei MIAO; Jie ZHONG

白话标题:双气囊小肠镜对小肠克罗恩病患者小剂量硫唑嘌呤治疗后黏膜修复的评估作用
作者: Lifen YU ; Shidan CHENG ; Tianyu ZHANG ; Yonghua TANG ; Fei MIAO ; Jie ZHONG
出版类型:Journal Article
关键字: Small intestine; Crohn's disease; Azathioprine; Mucosal healing; Double-bal-loon enteroscopy
来源: Chinese Journal of Digestive Endoscopy 2014;(9):489-493
国家China
语言:Chinese
摘要: Objective To evaluate the clinical value of double-balloon enteroscopy( DBE)in as-sessing the effect of mucosal healing in patients with moderate small bowel Crohn's disease( CD)treated with low-dose azathioprine. Methods CD patients who were naive to any immunomodulators or biological a-gents with lesions mainly located in ileu were screened by multislice CT enterography and anal-route DBE at baseline. Lesions at 150 cm proximal to ileocecal valve were assessed by DBE with Simple Endoscopic Score for CD( SES-CD)after 12 and 24 months of low-dose azathioprine treatment,respectively. Results A total of 36 patients were enrolled and the average tolerated dose of azathioprine was(61. 8 ± 17. 2)mg/day. The total rates of complete,near-complete,partial and no mucosal healing in 36 patients were 19. 4%(7/36), 5. 6%(2/36),27. 8%(10/36),and 47. 2%(17/36)at month 12 and 30. 6%(11/36),25. 0%(9/36), 33. 3%(12/36),and 11. 1%(4/36)at month 24,respectively. The baseline SES-CD score(OR=2. 71, 95%CI:1. 11-6. 63,P=0. 029)and duration of disease(OR=1. 27,95%CI:1. 10-1. 47,P =0. 001) were two relevant factors associated with mucosal healing of small bowel CD. Conclusion DBE has a signif-icant advantage in assessing post-therapy mucosal healing for patients with small bowel CD. The optimal time point for the first follow-up by DBE is at least 12 months after low-dose azathioprine treatment.