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慢性 炎 の 診断 と 治療: レビュー
Vikesh K Singh1, Dhiraj Yadav2, Pramod K Garg3
1Division of Gastroenterology, Department of Medicine, Johns Hopkins Medical Institutions, Baltimore, Maryland.
JAMA
|December 21, 2019
まとめ
慢性炎はアルコール,喫煙,遺伝によって引き起こされる痛ましい臓疾患です. マネジメントは ライフスタイルの変化や 痛みを和らげ 糖尿病や消化器系の問題に対処することに 焦点を当てています
科学分野:
- 胃腸科と肝臓科
- 臓疾患
- 内科 医学
背景:
- 慢性炎 (CP) は,100,000人に42~73人が罹患する炎症性および線維性臓疾患である.
- 遺伝的傾向と 過剰なアルコール摂取や喫煙などの 環境要因の両方が CP の病原化に寄与します
- CP症例の有意な部分は,多くの患者でSPINK1,CFTR,またはPRSS1遺伝子の遺伝子変異が確認されています.
研究 の 目的:
- 慢性性炎の原因,臨床表現,診断方法,治療戦略を見直す.
- 環境と遺伝的要因がCPの発展に与える影響を強調する.
- CPの症状と長期的後遺症の管理のための現在の治療アプローチを概説します.
主な方法:
- 慢性炎の病因,診断,治療に関する研究の文献レビュー.
- CPの流行と危険因子に関する疫学データの分析
- CP管理に関する臨床ガイドラインと研究成果のまとめ
主要な成果:
- アルコール乱用と喫煙は CP の重要な環境リスク因子です.
- 遺伝的変異 (SPINK1,CFTR,PRSS1) はイディオパシーおよび遺伝的形態のCPに関連しています.
- 常見の症状は慢性的な腹痛で,長期的には糖尿病と外分泌不全のリスクがあります.
結論:
- CPの管理には,ライフスタイルの変更,痛み管理,および臓不全の対処を含む多面的なアプローチが必要です.
- 診断画像 (CT,MRI,EUS) は,臓の化や管道の変化を特定するために不可欠です.
- 治療戦略には,アルコールや喫煙の断絶,鎮痛薬,臓酵素置換,そしていくつかの場合,管道阻害のための内視鏡または外科的介入が含まれます.
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