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血管发育不良概述:管理和患者前景。

An overview of angiodysplasia: management and patient prospects.

机构信息

a Department of Gastroenterology and Clinical Medicine , Trinity Centre for Health Sciences' Tallaght Hospital , Dublin , Ireland.

出版信息

Expert Rev Gastroenterol Hepatol. 2018 Sep;12(9):863-872. doi: 10.1080/17474124.2018.1503532. Epub 2018 Aug 3.

Abstract

Gastrointestinal angiodysplasias (GIADs) have a wide variety of presentations, which can be significant and debilitating in a subset of patients. Endoscopic ablation is currently the most effective treatment for GIADs, however re-bleeding rates are high. Several medical have been used for GIADs and reported in the literature, however these medications have significant side effect profiles and randomized controlled trials are lacking. A relatively poor understanding of the pathophysiology of GIAD formation has limited the development of more effective treatments and improved diagnostic and prognostic markers for GIAD. However, recent advances in research in the area of angiogenesis have identified a potential role for certain angiogenic factors including Angiopoeitin 1 and 2, in the pathophysiology of GIAD. Areas covered: We performed an extensive pubmed search of all articles mentioning GIAD and summarized our findings focussing on patient management and prospects. We summarize the available literature regarding the medical, endoscopic, and radiological management of GIAD and the value of clinical prognostic factors. Expert commentary: Although the area of angiogenesis is a novel area of research in GIAD, it represents an exciting avenue for development with the potential to improve diagnostic and prognostic tools to improve patient outcome.

摘要

胃肠道血管发育不良(GIAD)有多种表现形式,在一部分患者中,这些表现形式可能很严重且使人虚弱。内镜消融术是目前治疗 GIAD 的最有效方法,但再出血率很高。已有多种药物用于治疗 GIAD,并在文献中报道,但这些药物具有明显的副作用,且缺乏随机对照试验。对 GIAD 形成的病理生理学的认识相对较差,限制了更有效治疗方法的发展,并改善了 GIAD 的诊断和预后标志物。然而,该领域在血管生成方面的研究进展,确定了某些血管生成因子(包括血管生成素 1 和 2)在 GIAD 病理生理学中的潜在作用。

涵盖领域

我们对所有提到 GIAD 的文章进行了广泛的 PubMed 搜索,并对我们的发现进行了总结,重点关注患者的管理和前景。我们总结了 GIAD 的药物、内镜和放射学管理以及临床预后因素的价值的相关文献。

专家评论

尽管血管生成领域是 GIAD 的一个新的研究领域,但它代表了一个令人兴奋的发展方向,有可能改善诊断和预后工具,从而改善患者的预后。

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