- 作者：Ofer Ben&ndash ; Bassat&lowast ; ; &Dagger ; ; § ; ; a ; Andrea D. Tyler&lowast ; ; § ; ; a ; Wei Xu鈥?/sup> ; Richard Kirsch¶ ; ; David F. Schaeffer¶ ; ; Joanna Walsh¶ ; ; A. Hillary Steinhart&Dagger ; ; # ; Gordon R. Greenberg&Dagger ; ; # ; Zane Cohen&lowast ; ; &lowast ; &lowast ; ; &Dagger ; &Dagger ; ; Mark S. Silverberg&lowast ; ; &Dagger ; ; § ; ; # ; b ; msilverberg@mtsinai.on.ca" class="auth_mail ; Robin S. McLeod&lowast ; ; § ; ; &lowast ; &lowast ; ; &Dagger ; &Dagger ; ; § ; § ; ; b
- 关键词：Ileal Pouch&ndash ; Anal Anastomosis ; Inflammatory Bowel Disease ; Pouchitis ; Ulcerative Colitis
- 刊名：Clinical Gastroenterology and Hepatology
- 出版年：May, 2014
- 年：2014
- 卷：12
- 期：5
- 页码：831-837.e2
- 全文大小：245 K
Background & Aims
Pouchitis is the most common complication after ileal pouch-anal anastomosis (IPAA). However, symptoms are not specific. The Pouchitis Disease Activity Index (PDAI) and the Pouchitis Activity Score (PAS) have been used to diagnose pouchitis. We evaluated the correlation between the clinical components of these scores and endoscopic and histologic findings.Methods
We performed a cross-sectional study, analyzing data from 278 patients from Mount Sinai Hospital (Toronto, Canada) who had an IPAA. Patients underwent pouchoscopy with a biopsy, and data were collected on patients' clinical status. The PDAI and PAS were calculated for each subject. The Spearman rank correlation (蟻) statistical test was used to evaluate correlations between the PDAI scores and PAS, and between total scores and subscores.
Results
The total PDAI scores and PAS scores were correlated; the clinical components of each correlated with the total score (蟻聽= 0.59 and 蟻聽= 0.71, respectively). However, we observed a low level of correlation between clinical and endoscopic or histologic subscores, with 蟻 of 0.20 and 0.10, respectively, by PDAI, and 蟻 of 0.19 and 0.04, respectively, by PAS.
Conclusions
There is a low level of correlation between clinical and endoscopic and histologic subscores of patients with IPAA; clinical symptoms therefore might not reflect objective evidence of inflammation. These findings, along with evidence of correlation between total scores and clinical symptoms, indicate that these indices do not accurately identify patients with pouch inflammation. Further research is required to understand additional factors that contribute to clinical symptoms in the absence of objective signs of pouch inflammation.