gnckКолопроктологияKoloproktologia2073-75562686-7303Russian Association of Coloproctology10.33878/2073-7556-2024-23-1-172-180gnck-1880Research ArticleОБЗОРЫ ЛИТЕРАТУРЫ И МЕТААНАЛИЗLITERATURE REVIEWS AND METAANALYSISПредикторы неблагоприятного исхода терапии кортикостероидами у пациентов с тяжелой атакой язвенного колита (систематический обзор и метаанализ)Predictors of adverse outcomes of steroids in patients with severe ulcerative colitis (systematic review and meta-analyses)https://orcid.org/0000-0002-4558-560XМингазовА. Ф.MingazovA. F.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya st., 2, Moscow, 123423

polikarpova-e@yandex.ruhttps://orcid.org/0000-0001-9780-7916СушковО. И.SushkovO. I.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya st., 2, Moscow, 123423

https://orcid.org/0009-0001-4679-5756КалановБ. Р.KalanovB. R.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya st., 2, Moscow, 123423

https://orcid.org/0000-0003-2013-8798БарановаТ. А.BaranovaT. A.

ул. Саляма Адиля, д. 2, г. Москва, 123423

Salyama Adilya st., 2, Moscow, 123423

https://orcid.org/0000-0001-9294-5447АчкасовС. И.AchkasovS. I.

ул. Саляма Адиля, д. 2, г. Москва, 123423

ул. Баррикадная, д. 2/1, стр. 1, г. Москва, 125993

Salyama Adilya st., 2, Moscow, 123423

Barrikadnaya st., 2/1, Moscow, 125993

ФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава РоссииРоссияRyzhikh National Medical Research Center of ColoproctologyRussian FederationФГБУ «НМИЦ колопроктологии имени А.Н. Рыжих» Минздрава России; ФГБОУ ДПО РМАНПО Минздрава РоссииРоссияRyzhikh National Medical Research Center of Coloproctology; Russian Medical Academy of Continuous Professional EducationRussian Federation202421032024231172180Copyright © Мингазов А.Ф., Сушков О.И., Каланов Б.Р., Баранова Т.А., Ачкасов С.И., 20242024Мингазов А.Ф., Сушков О.И., Каланов Б.Р., Баранова Т.А., Ачкасов С.И.Mingazov A.F., Sushkov O.I., Kalanov B.R., Baranova T.A., Achkasov S.I.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.ruproctology.com/jour/article/view/1880ЦЕЛЬ

ЦЕЛЬ: выявить предикторы гормональной резистентности у пациентов с тяжелой атакой язвенного колита (ЯК).

ПАЦИЕНТЫ И МЕТОДЫ

ПАЦИЕНТЫ И МЕТОДЫ: проведен систематический обзор и метаанализ, включено 18 обсервационных исследований по типу «случай-контроль» и 2545 пациентов с тяжелой атакой ЯК.

РЕЗУЛЬТАТЫ

РЕЗУЛЬТАТЫ: доля пациентов, у которых терапия кортикостероидами оказалась эффективной, составила 69,5%, а гормональная резистеность развилась в 30,5% случаев. Тотальное поражение слизистой оболочки толстой кишки (ОШ = 1,5 95% ДИ: 1,1–2) и эндоскопическая картина по шкале UCEIS ≥ 7 баллов (ОШ = 4,5; 95% ДИ: 3,2–6,5) явились предикторами гормональной резистентности. Уровень альбумина и С-реактивного белка перед началом и на 3 сутки проводимого лечения кортикостероидами также статистически значимо корреспондировали с развитием неблагоприятного исхода лечения — гормональной резистентности (p < 0,00001).

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: по результатам проведенного метаанализа, предикторами неблагоприятного исхода — гормональной резистентности являлись тотальное поражение слизистой оболочки толстой кишки, а также эндоскопическая картина по шкале UCEIS ≥ 7 баллов. Также гипоальбуминемия и высокий уровень С-реактивного белка ассоциированы с развитием гормональной резистентности.

AIM

AIM: to identify predictors of steroid resistance among patients with severe ulcerative colitis (UC).

PATIENTS AND METHODS

PATIENTS AND METHODS: the systematic review and meta-analysis were done, 18 observational case-control studies and 2545 patients with severe UC were included.

RESULTS

RESULTS: the rate of patients with effective steroid therapy was 69.5%, and steroid resistance occurred in 30.5%. Pancolitis (OR = 1.5; 95% CI: 1.1–2) and endoscopic picture on the UCEIS ≥ 7 points (OR = 4.5; 95% CI: 3.2–6.5) were predictors of steroid resistance. The levels of albumin and C-reactive protein before the start and on the 3rd day of steroid treatment were also significantly corresponded with adverse outcome of the treatment (p < 0.00001). CONCLUSION: predictors of an adverse outcome are steroid resistance with pancolitis and endoscopic picture on the UCEIS scale ≥ 7 points. Hypoalbuminemia and high level of C-reactive protein were associated with the steroid resistance as well.

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The authors declare that there are no conflicts of interest present.