系统性审查:炎症性肠病中的严重内镜性病变
Gaëlle Tyrode1,2, Pauline Rivière2, Shaji Sebastian3
1Department of Gastroenterology, University Hospital of Besançon, Besançon, France.
Journal of Crohn's & colitis
|February 19, 2025
概括
在炎症性肠病 (IBD) 中,严重内镜性病变 (SEL) 缺乏经过验证的定义. 虽然在急性严重性结肠炎 (ASUC) 和克罗恩病 (CD) 中很常见,但SEL在ASUC中预测了类固醇失效,但在任何IBD类型中都没有抗TNF反应.
科学领域:
- 胃肠病学 胃肠病学
- 临床医学 临床医学
- 内镜研究 内镜研究
背景情况:
- 内镜和活检是诊断炎症性肠病 (IBD) 和评估治疗的标准.
- 严重的内镜病变 (SEL) 在IBD中很常见,但缺乏详细描述.
- 本综述综合了当前的知识,并确定了IBD中SEL的研究缺口.
研究的目的:
- 提供当前对炎症性肠病 (IBD) 中严重内镜病变 (SEL) 的理解概述.
- 确定有关SEL的定义,患病率和预后影响的文献上的差距.
主要方法:
- 对IBD患者严重内镜病变 (SEL) 的研究进行系统审查.
- 在2024年7月的MEDLINE,Embase和Cochrane CENTRAL数据库中进行了搜索.
- 包括调查SEL定义,疾病参与,治疗演变和预后意义的研究.
主要成果:
- 从最初确定的1172项研究中,包括了46项研究.
- 没有SEL的验证定义存在;定义依赖于未经验证的严重内镜项目.
- 患病率估计:急性严重性结肠炎 (ASUC) 的33%-75%,克罗恩病 (CD) 的22.5%-87%.
- 在ASUC中,SEL与类固醇折射性相关;对因弗利克西马布/环素反应没有影响.
- 在CD中,SEL不会影响对生物药物的反应,包括抗TNF药物.
结论:
- 目前,IBD中严重内镜病变 (SEL) 的验证定义尚缺.
- 在ASUC中,SEL存在与类固醇失败相关.
- 在克罗恩病或ASUC中,SEL不会影响抗TNF治疗反应.
相关概念视频
01:21Inflammatory Bowel Disease V: Surgical Management
95
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
95
01:30Inflammatory Bowel Disease II: Crohn's Disease
166
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
166
01:17Chronic Bowel Disorders: Introduction
380
Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
380
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
122
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
122
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
301
Various diagnostic tests are employed in the diagnostic process for Inflammatory Bowel Disease (IBD), particularly to differentiate between Crohn's disease and ulcerative colitis.
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...
301
01:29Inflammatory Bowel Disease IV: Pharmacological Management
95
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
95