Georgia Health Sciences University, Augusta, 30912, USA.
Am Fam Physician. 2011 Dec 15;84(12):1365-75.
Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn's disease include osteoporosis, inflammatory arthropathies, scleritis, nephrolithiasis, cholelithiasis, and erythema nodosum. Acute phase reactants, such as C-reactive protein level and erythrocyte sedimentation rate, are often increased with inflammation and may correlate with disease activity. Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status. Colonoscopy with ileoscopy, capsule endoscopy, computed tomography enterography, and small bowel follow-through are often used to diagnose Crohn's disease. Ultrasonography, computed axial tomography, scintigraphy, and magnetic resonance imaging can assess for extraintestinal manifestations or complications (e.g., abscess, perforation). Mesalamine products are often used for the medical management of mild to moderate colonic Crohn's disease. Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment. Patients with moderate to severe Crohn's disease are treated with corticosteroids, azathioprine, 6-mercaptopurine, or anti-tumor necrosis factor agents (e.g., infliximab, adalimumab). Severe disease may require emergent hospitalization and a multidisciplinary approach with a family physician, gastroenterologist, and surgeon.
克罗恩病是一种慢性炎症性疾病，可影响从口腔到直肠的胃肠道的任何部位。患者可能会出现腹泻、腹痛、发热、体重减轻、腹部肿块和贫血等症状。克罗恩病的肠外表现包括骨质疏松症、炎性关节炎、巩膜炎、肾结石、胆结石和结节性红斑。急性反应蛋白，如 C 反应蛋白水平和红细胞沉降率，常随炎症而增加，并且可能与疾病活动度相关。维生素 B12、叶酸、白蛋白、前白蛋白和维生素 D 的水平有助于评估营养状况。结肠镜检查联合小肠镜检查、胶囊内镜检查、计算机断层扫描肠造影术和小肠钡剂灌肠检查通常用于诊断克罗恩病。超声、计算机轴向断层扫描、闪烁扫描和磁共振成像可用于评估肠外表现或并发症（如脓肿、穿孔）。美沙拉嗪产品常用于轻度至中度结肠克罗恩病的药物治疗。抗生素（如甲硝唑、氟喹诺酮类药物）常被用于治疗。对于中度至重度克罗恩病患者，使用皮质类固醇、巯嘌呤、6-巯基嘌呤或抗肿瘤坏死因子药物（如英夫利昔单抗、阿达木单抗）进行治疗。严重疾病可能需要紧急住院治疗，并且需要由家庭医生、胃肠病学家和外科医生组成的多学科团队进行治疗。
