微观结肠炎:基于证据的诊断和管理指南
Sara Ghoneim1, Michael G Drage2, Kristin E Burke1
1Division of Gastroenterology, Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA;
微观性结肠炎 (MC) 引起水性腹,主要发生在老年人身上. 虽然布德索尼德在初始治疗中是有效的,但高复发率需要探索这种慢性炎症性肠病的维持疗法.
科学领域:
- 胃肠病学 胃肠病学
- 免疫学 免疫学 免疫学
- 病理学 病理学 病理学
背景情况:
- 微观性结肠炎 (MC) 是一种慢性炎症性肠病,影响老年人,呈现出水性腹.
- 诊断依赖于组织学,因为内镜检查结果并不显著,缺乏非侵入性生物标志物.
- MC亚型包括淋巴细胞和原性结肠炎.
研究的目的:
- 审查微观结肠炎的诊断和治疗.
- 讨论MC目前和潜在的长期管理策略.
- 为了突出高复发率带来的挑战.
主要方法:
- 关于微观结肠炎诊断和治疗的文献综述.
- 对当前治疗指南和新兴策略的分析.
- 综合了关于布索尼德疗效和维护选项的信息.
主要成果:
- 布德索尼德 (9毫克/天6-8周) 是有效的第一线疗法,用于诱导MC的缓解.
- 在初始布索尼德治疗后,观察到高复发率.
- 长期的策略包括低剂量布索尼德,胆盐结合剂,抗腹药,以及耐火病例的先进疗法.
结论:
- 对MC存在有效的诱导疗法,但持续缓解仍然是一个挑战.
- 对长期维护和先进疗法的进一步研究对于管理复发性MC至关重要.
- 优化治疗策略对于改善微观结肠炎患者的治疗结果至关重要.
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