궤양성 대장염 환자의 질병 활성도 평가를 위한 내시경 검사법

Abstract

Background and Aim: Ulcerative colitis (UC) is a chronic inflammatory bowel disease of un-known etiology and is a lifelong disease that repeat clinical improvement and aggravation. The se-verity of disease determines the course of disease and prognosis of patients and the endoscopic se-verity assessment is very important. Ulcerative colitis is characterized by the presence of continuous mucosal lesions and most of case is placed in the left colon. Colonoscopy is able to identify the en-tire field, but the preparation process is difficult and expensive modality. The aims of this study are to evaluate the endoscopic modality for assessment of severity of ulcerative colitis during follow up and to know whether there is agreement between sigmoidoscopy and colonoscopy or not. Method: The subjects were 183 UC patients who were diagnosed and followed up at Chosun Uni-versity Hospital from 2012 January to 2017 December. Among them, 101 patients with follow-up colonoscopy were enrolled and retrospectively evaluated for endoscopic severity. Endoscopic find-ing is divided into entire colon and rectosigmoid colon. The scale of endoscopic severity is endo-scopic Mayo score and ulcerative colitis endoscopic index scale (UCEIS), scores are assigned to each site and an agreement analysis was performed Result: The average of endoscopic Mayo score of entire colon is 1.21and in case of rectosigmoid colon is 1.07. The average of UCEIS of entire colon is 2.24 and in case of rectosigmoid colon is 1.94. The agreement endoscopic Mayo score between the each site is observed with a kappa value of 0.83 (p=0.00), and agreement of UCEIS between the each site is observed with a kappa value of 0.840 (p=0.00) Conclusion: In endoscopic evaluation of disease severity at follow - up in patients with ulcerative colitis, there is a very high level of agreement between colonoscopy and sigmoidoscopy.