Meta-analysis Of Cytomegalovirus Infection In Severe Ulcerative Colitis Infection And Antiviral Therapy On Its Impact

Ulcerative colitis(UC) is a chronic, non-specific inflammatory disease.Among them, severe ulcerative colitis is a more serious stage of disease progression. If it is not treated inappropriately, it will has serious consequences such as infection, toxic megacolon and bowel perforation. Currently the main treatment medicine is glucocorticoids in vein. Because of the intestinal lesions illness itself heavier and immune inhibitor application combined with hormone, severe ulcerative colitis patients easily combine the opportunistic infections and cytomegalovirus is one of them.Can aggravate the CMV infection and can cover the treatment effect, so a clear presence of CMV infection and timely intervention is vital for the treatment of severe ulcerative.CMV is a kind of opportunistic pathogens, it can cause the body latent infections.When some special situation(massive application of hormone and immune inhibitors) occurs, the body’s immune function is impaired, make a dormant cytomegalovirus, can cause systemic infection. Intestinal infection is one of its main parts.Currently on the state of CMV infection in severe ulcerative colitis is not fully clear, there has been reported the CMV infection rate increased obviously in the refractory ulcerative colitis, and its infection in severe ulcerative colitis is unclear.To have merged cytomegalovirus infection of severe ulcerative colitis, whether to need to antiviral treatment? The prognosis of patients with antiviral treatment for what? There are a lot of small sample study.Reason for ulcerative colitis especially severe ulcerative colitis patients with CMV infection, it is not clear whether you need to have merged cytomegalovirus infection in patients with antiviral treatment, it is unable to provide clinicians with a more reasonable and correct guidance.Objective: By searching for almost 10 years at home and abroad about the CMV infection status in mild-to-moderate and severe ulcerative colitis in the related literature, the meta analysis of the literature of the, in order to make clear cytomegalovirus in different severity of the disease infection;At the same time search in recent 10 years at home and abroad about the research of severe ulcerative colitis merge the antiviral therapy and prognosis of cytomegalovirus infection related literature, on the meta analysis, for severe ulcerative colitis merger provides the theory basis for the processing of cytomegalovirus infection.Method: We searched Pub Med, Wan fang data bases, CQVIP databases and CNKI to retrieve relevant studies. Collect related research of CMV infection status in mild-to-moderate and severe ulcerative colitis of related literature, Through AMSTAR scale to evaluate quality of selected articles one by one. Meta-analyses were performed for the included case-control studies using Rev Man4.2 software.Results : The study included 9 researchers, were included in the meta-analysis, which were divided into two parts for the different aspects. The first part mainly analysis of cytomegalovirus infection in mild-to-moderate and severe ulcerative colitis. Sample according to the literature, and finally to analysis the histologic examination of the CMV infection in different severity of ulcerative colitis. It showed significant difference between ulcerative colitis cytomegalovirus infection situation of the group and the control group(P=0.0001,OR=11.36,95%CI(1.61-80.23).The severe ulcerative colitis patients with cytomegalovirus infection are 11.36 rates to mild-to-moderate infection of ulcerative colitis.really high than the mild-to-moderate The second part mainly analysis has merged cytomegalovirus infection of severe ulcerative colitis response antiviral therapy, mainly from the relieving time, relapse and recent clinical. It included 5 articles; there are 2 articles among them which mentioned the effect on the clinical remission of antiviral treatment. The results showed significant difference in the two controls, P=0.000, OR=3.33, 95%CI(1.45-7.55),that is to say, the clinical remission in treatment group are 3.33 rates to untreatment group. Another group including 2 articles about the clinical relapse in treatment group and untreatment group. The results showed significant difference in the two controls, P=0.228, OR=4.38, 95%CI(1.50-12.63).The short-term and the long-term of the clinical course. The analysis of antiviral treatment taken or not taken, the clinical ease and surgical removal of the situation for patients with CMV positive, Calculated the CMV infection and antiviral treatment in patients with long-term, short-term prognosis of clinical ease and the influence of the short term. The result is about CMV infection and its antiviral treatment effect on the prognosis of patients with long-term, short-term It included 5 articles; there are 4 articles among them which mentioned the effect of surgery by early antiviral treatment. The results showed no significant difference in the two controls, P=0.050, OR=0.71, 95%CI(0.26-1.95). And the analysis of antiviral therapy and long-term colon resection in patients also showed no significant difference by evaluate the selection of another five articles on long-term follow-up of patients about colon resection risk, P=0.971, OR=1.04, 95%CI(0.42-2.56).Conclusions: Cytomegalovirus infection in severe ulcerative colitis is significantly higher, moderate infection in patients with ulcerative colitis is about 11.36 times as much. For consolidated cytomegalovirus infection of severe ulcerative colitis, antiviral therapy can improve clinical relief, reduce clinical relapse,but for the early and long-term follow-up not significantly affect the risk of surgery.