Department of Gastroenterology, CHU Liège, Liège University, 4000 Liège, Belgium.
World J Gastroenterol. 2010 Jun 7;16(21):2600-3. doi: 10.3748/wjg.v16.i21.2600.
While therapeutic strategies able to change the natural history of the disease are developing, it is of major importance to have available predictive factors for aggressive disease to try and target these therapeutic strategies. Clinical predictors have probably been the most broadly studied. In both Crohn's disease (CD) and ulcerative colitis (UC), age at diagnosis, disease location and smoking habit are currently the strongest predictors of disease course. A younger age at onset is associated with more aggressive disease both in CD and UC. Disease location in CD is associated with different types of complications: surgery and recurrence in upper gastrointestinal and proximal small bowel disease; and surgery in distal small bowel disease and peri-anal lesions in rectal disease. In UC, extensive colitis is clearly been associated with more severe disease. Finally, active smoking globally increases disease severity in CD but decreases it in UC. Besides these important factors, others may predispose to some specific disease evolution and complications, and are also reviewed in the present paper.
虽然能够改变疾病自然史的治疗策略正在不断发展，但拥有预测侵袭性疾病的预测因素来尝试针对这些治疗策略至关重要。临床预测因素可能是研究最广泛的。在克罗恩病 (CD) 和溃疡性结肠炎 (UC) 中，诊断时的年龄、疾病部位和吸烟习惯是目前疾病过程的最强预测因素。发病年龄越小，CD 和 UC 中的疾病侵袭性越强。CD 的疾病部位与不同类型的并发症有关：上消化道和近端小肠疾病的手术和复发；以及远端小肠疾病和直肠疾病的肛周病变的手术。在 UC 中，广泛性结肠炎显然与更严重的疾病有关。最后，吸烟会增加 CD 患者的疾病严重程度，但会降低 UC 患者的疾病严重程度。除了这些重要因素外，其他因素也可能导致某些特定的疾病进展和并发症，本文也对此进行了综述。
