Beck I T
Department of Medicine, Queen's University, Kingston, Ontario, Canada.
Dig Dis Sci. 1987 Dec;32(12 Suppl):26S-41S. doi: 10.1007/BF01312461.
Presently there are no specific laboratory tests to diagnose inflammatory bowel disease (IBD). Nonspecific tests to differentiate diarrhea due to mucosal injury from that occurring in patients with normal bowel mucosa (eg, fecal occult blood, leukocytes, etc) are not helpful. Tests to exclude infections agents are very important, since the clinical and radiological appearance of these may mimic IBD, and patients with IBD may suffer from superinfection. There are no laboratory tests which can differentiate Crohn's colitis from ulcerative colitis (UC). The tests used in the assessment and management of severely ill patients (Hgb, WBC, electrolytes, etc) are important, since abnormalities need to be corrected on an ongoing basis. The tests used to assess nutritional status are of little clinical value, since "clinical assessment" is as good as the laboratory assessment. Estimation of disease activity by tests is rarely better than the judgment of the clinician. Workup for malabsorption in Crohn's disease and the assessment of absorptive capacity of the terminal ileum are important for proper planning of management. Laboratory tests are also useful in clarifying the nature of some complications (eg, anemias and joint diseases).
目前尚无特异性实验室检查来诊断炎症性肠病（IBD）。用于区分黏膜损伤所致腹泻与肠黏膜正常患者腹泻（如粪便潜血、白细胞等）的非特异性检查并无帮助。排除感染因素的检查非常重要，因为这些感染的临床和影像学表现可能与IBD相似，且IBD患者可能会发生重叠感染。没有实验室检查能够区分克罗恩结肠炎和溃疡性结肠炎（UC）。用于评估和处理重症患者的检查（血红蛋白、白细胞、电解质等）很重要，因为需要持续纠正异常情况。用于评估营养状况的检查临床价值不大，因为“临床评估”与实验室评估效果相当。通过检查评估疾病活动度很少能比临床医生的判断更准确。对克罗恩病吸收不良的检查以及对回肠末端吸收能力的评估对于合理规划治疗很重要。实验室检查在明确某些并发症（如贫血和关节疾病）的性质方面也很有用。
