| 特集名 | 潰瘍性大腸炎―長期経過観察例の諸問題 | |
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| 題名 | 再燃の因子となるものは？ | |
| 発刊年月 | 2011年 07月 | |
| 著者 | 大藤 さとこ | 大阪市立大学大学院医学研究科公衆衛生学 |
| 著者 | 福島 若葉 | 大阪市立大学大学院医学研究科公衆衛生学 |
| 著者 | 廣田 良夫 | 大阪市立大学大学院医学研究科公衆衛生学 |
| 【 要旨 】 | 潰瘍性大腸炎は原因不明の難治性炎症性腸管障害であり，経過中に寛解と再燃を繰り返す者が多い．診断後1年間の再燃率は約30〜50％，5年では約60〜70％と報告されている．しかし，再燃率は診断時の病態により影響を受けるため，報告により若干のばらつきがある． 再燃に影響する因子として，診断時の年齢，病変部位，重症度などがある．しかし，その他の因子については再燃因子というには論拠が希薄である．また，家族歴，喫煙，虫垂切除歴など潰瘍性大腸炎の発生に関連する因子は，必ずしも再燃に強く影響しているわけではなさそうである． 再燃に影響する因子の解明は，患者の寛解維持効果を向上させるためにも重要な検討課題である． |
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| Theme | Various Subjects of Long-term Following Patients with Ulcerative Colitis | |
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| Title | Potential Predictors for Relapse of Ulcerative Colitis | |
| Author | Satoko Ohfuji | Department of Public Health, Osaka City University Graduate School of Medicine |
| Author | Wakaba Fukushima | Department of Public Health, Osaka City University Graduate School of Medicine |
| Author | Yoshio Hirota | Department of Public Health, Osaka City University Graduate School of Medicine |
| [ Summary ] | Ulcerative colitis (UC) is a chronic inflammatory bowel disease with unknown etiology, which follows courses of remission and relapse. Previous reports have indicated that the risk of relapse was about 30-50 % at one year and about 60-70 % at 5 years after diagnosis. However, the risk was interpreted in various ways according to the study, since the relapse could be affected by several factors including disease status at the time of diagnosis. The potential predictors for risk of relapse were younger age, disease expansion and disease severity at the time of diagnosis. Regarding other factors including life style, however, there was limited evidence concerning association with relapse. In addition, factors which are strongly related to onset of UC (i. e., smoking, appendectomies and family history) are not always associated with relapse. Life style factors, such as smoking and diet, may be less important than prior disease activity in determining the risk of relapse but clinically much more important because the factors are potentially modifiable. Further studies are needed to explore potential risk factors for relapse including life style, which may be useful to improve disease course and to achieve increases in cumulative rates of remission. |
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