炎症性肠病的新型诊断和预后方法。

Novel diagnostic and prognostic modalities in inflammatory bowel disease.

作者信息

Zisman Timothy L, Rubin David T

机构信息

Division of Gastroenterology, University of Washington Medical Center, 1959 NE Pacific Street, Box 356424, Seattle, WA 98195, USA.

出版信息

Med Clin North Am. 2010 Jan;94(1):155-78. doi: 10.1016/j.mcna.2009.10.003.

DOI:10.1016/j.mcna.2009.10.003

PMID:19944803

Abstract

Inflammatory bowel disease remains a complex disease with variable clinical presentations and often nonspecific symptoms. Physicians must rely on diagnostic tools for clarification of disease diagnosis and for guiding management of patients with established disease. Advances in radiologic imaging modalities facilitate early and accurate detection of luminal disease and extraluminal complications. The introduction and dissemination of small bowel capsule endoscopy and double-balloon enteroscopy permit detailed visualization and sampling of the mucosa throughout the entire bowel. Serologic biomarkers are evolving as a valuable tool to clarify diagnosis and stratify patients by disease phenotypes and patterns of behavior. Neutrophil-derived fecal biomarkers are emerging as useful surrogate markers of intestinal inflammation with the potential for a variety of clinical applications, but their application to clinical management has not yet been clarified.

摘要

炎症性肠病仍然是一种复杂的疾病，临床表现多样且症状往往不具特异性。医生必须依靠诊断工具来明确疾病诊断并指导已确诊疾病患者的治疗。放射影像学检查手段的进步有助于早期准确检测管腔疾病和管腔外并发症。小肠胶囊内镜和双气囊小肠镜的引入与推广，使得能够对整个肠道的黏膜进行详细观察和取样。血清生物标志物正逐渐成为一种有价值的工具，可用于明确诊断并根据疾病表型和行为模式对患者进行分层。中性粒细胞衍生的粪便生物标志物正成为肠道炎症的有用替代标志物，具有多种临床应用潜力，但其在临床治疗中的应用尚未明确。