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[炎症性肠病患者的非侵入性随访]

[Non-invasive follow up of patients with inflammatory bowel diseases].

作者信息

Nancey Stephane, Roblin Xavier

出版信息

Rev Prat. 2014 Nov;64(9):1256-61.

Abstract

The management of inflammatory bowel diseases (IBD) is widely guided by biomarkers and cross-sectional imaging, which represent non-invasive tools for making therapeutic decision. The measurement of CRP is widely used in daily practice and is useful to identify a flare, to follow the response to therapy, and to predict relapse. The dosage of fecal calprotectin is better correlated with the severity of endoscopic lesions when compared with CRP and is overall more accurate to identify an active IBD and to predict a relapse. The measurement of trough levels and antidrug antibodies is useful in case of loss of response and some algorithms have been proposed for a personalized and optimized therapy. Monitoring IBD patients with entero-MRI is a standard allowing to assess disease activity and extension of the lesions and also to detect complications. The optimal frequency of the dosage of biomarkers and of MRI warrants to be determined.

摘要

炎症性肠病(IBD)的管理广泛地以生物标志物和横断面成像为指导,这些代表了用于做出治疗决策的非侵入性工具。CRP的测量在日常实践中广泛应用,有助于识别疾病发作、跟踪治疗反应以及预测复发。与CRP相比,粪便钙卫蛋白的测定与内镜病变的严重程度相关性更好,总体上在识别活动性IBD和预测复发方面更准确。谷浓度水平和抗药物抗体的测定在治疗反应丧失的情况下很有用,并且已经提出了一些算法用于个性化和优化治疗。用肠道MRI监测IBD患者是一种标准方法,可用于评估疾病活动度和病变范围,还能检测并发症。生物标志物测定和MRI检查的最佳频率有待确定。

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