Stallmach A, Bürger M, Weber M
Klinik für Innere Medizin IV (Gastroenterologie, Hepatologie und Infektiologie), Universitätsklinikum Jena, Friedrich-Schiller-Universität, Erlanger Allee 101, Jena, Deutschland,
Internist (Berl). 2014 Aug;55(8):898-905. doi: 10.1007/s00108-013-3441-2.
A variety of diagnostic methods provide the necessary rational basis for diagnosis, assessment of disease activity and exclusion of possible complications for patients with inflammatory bowel disease (IBD).
Currently, a wide range of diagnostic methods is available and easily accessible. The clinical use of all these different methods is inherently possible. As there is no reference test for either diagnosis or monitoring of IBD, diagnostic techniques must be selected, applied and interpreted in an appropriate clinical context. The objective is to evaluate the clinical, laboratory and imaging techniques including ultrasound and endoscopy in different clinical situations.
In addition to clinical parameters, fecal calprotectin and abdominal ultrasound are helpful tools to assess the inflammatory activity. In patients with high inflammatory activity, a routine endoscopy is not beneficial. At best, endoscopy can be performed to document the extent of mucosal inflammation before initiating an intensified immunosuppressive therapy. Knowledge and experience in the management and treatment of IBD complications are critical in providing a rational use of specific diagnostic methods.
As a basic principle, the critical evaluation of diagnostic methods in patients with IBD is of great importance. Specific clinical situations require specific diagnostic techniques. Every diagnostic method performed should have a purpose.
多种诊断方法为炎症性肠病（IBD）患者的诊断、疾病活动度评估及可能并发症的排除提供了必要的合理依据。
目前，有多种诊断方法可供使用且易于获取。所有这些不同方法在临床中都有可能应用。由于IBD的诊断或监测均无参考标准测试，因此必须在适当的临床背景下选择、应用和解读诊断技术。目的是评估包括超声和内镜检查在内的临床、实验室及影像学技术在不同临床情况下的应用。
除临床参数外，粪便钙卫蛋白和腹部超声是评估炎症活动的有用工具。对于炎症活动度高的患者，常规内镜检查并无益处。至多，可在内镜检查在开始强化免疫抑制治疗前进行，以记录黏膜炎症的范围。IBD并发症管理和治疗方面的知识与经验对于合理使用特定诊断方法至关重要。
作为基本原则，对IBD患者诊断方法进行批判性评估非常重要。特定临床情况需要特定诊断技术。所执行的每种诊断方法都应有其目的。
