Herrlinger K R, Stange E F
Klinikum Heidberg, Hamburg, Deutschland.
Innere Medizin I, Universitätsklinikum Tübingen, Otfried-Müller-Straße 10, 72076, Tübingen, Deutschland.
Inn Med (Heidelb). 2025 Jan;66(1):55-63. doi: 10.1007/s00108-024-01826-9. Epub 2024 Dec 23.
The classic therapeutic goals of chronic inflammatory bowel disease (IBD) are, on the one hand, clinical remission and, on the other, the prevention of disease progression. The introduction of additional "targets" such as normalization of laboratory inflammation values, endoscopic and, possibly, histological mucosal healing and transmural parameters (ultrasound, magnetic resonance imaging and computed tomography) is intended to improve prognosis. A good response to therapy is usually (also) evident from these targets, although the obligatory change in medication in order to improve the prognosis if the additional treatment goals are not achieved is not evidence-based. In the case of Crohn's disease and ulcerative colitis, individual and, if possible, personalized medicine should continue to be provided instead of strict target specifications.
慢性炎症性肠病(IBD)的经典治疗目标,一方面是临床缓解,另一方面是预防疾病进展。引入额外的“目标”,如实验室炎症指标正常化、内镜检查以及可能的组织学黏膜愈合和透壁参数(超声、磁共振成像和计算机断层扫描),旨在改善预后。通常(也)能从这些目标中看出对治疗的良好反应,尽管为了改善预后在未达成额外治疗目标时强制更换药物并无循证依据。对于克罗恩病和溃疡性结肠炎,应继续提供个体化且尽可能个性化的医疗,而非严格的目标设定。