Role of endoscopy in predicting the disease course in inflammatory bowel disease
Role of endoscopy in predicting the disease course in inflammatory bowel disease
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DOI：
10.3748/wjg.v16.i21.2626
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发表时间：
2010-06-07
影响因子：
4.3
通讯作者：
Lemann, Marc
中科院分区：
文献类型：
--
作者：
Allez, Matthieu;Lemann, Marc
内窥镜检查可以直接评估炎症性肠病(IBD)中的粘膜病变，从而能够描述基本病变、其表面范围和严重程度。粘膜病变的严重程度直接反映了疾病的活动性，有助于识别疾病的侵袭性行为。最近有几项研究指出了内窥镜检查在预测IBD预后中的潜在作用。事实上，克罗恩病(CD)患者的严重内窥镜损伤，至少在结肠的一个部分出现深度和广泛的溃疡，与穿透并发症和手术的风险增加有关。在溃疡性结肠炎(UC)严重发作期间，严重的内窥镜损害与短期和长期内结肠切除的风险增加相关。CD术后复发的严重程度可能有助于预测临床复发的风险和是否需要进一步手术。粘膜愈合的实现可以通过几种类型的药物来实现，这与更好的结果、更少的手术和住院有关。这篇综述着重于CD和UC的内窥镜严重程度的评估，以及内窥镜严重程度对疾病结局的影响。更具体地说，我们讨论了如何在IBD的不同阶段使用内窥镜来预测疾病过程和/或调整治疗策略。(C)2010年白石登。版权所有。
Endoscopy provides a direct evaluation of mucosal lesions in inflammatory bowel disease (IBD), permitting the description of elementary lesions, their surface extent and severity. The severity of mucosal lesions directly reflects disease activity and may help to identify an aggressive behavior of the disease. Several studies have recently pointed out the potential role of endoscopy in the prediction of IBD outcome. Indeed, severe endoscopic lesions in Crohn's disease (CD) patients, defined by deep and extensive ulcerations on at least one part of the colon, are associated with an increased risk of penetrating complication and surgery. Severe endoscopic lesions during severe attacks of ulcerative colitis (UC) are associated with an increased risk of colectomy in the short and long term. Severity of postoperative recurrence in CD may help to predict the risk of clinical relapse and need for further surgery. Achievement of mucosal healing, which can be obtained by administration of several types of drugs, is associated with a better outcome, less surgery and hospitalization. This review focuses on the assessment of endoscopic severity in CD and UC and on the impact of endoscopic severity on disease outcome. More specifically, we discuss how endoscopy can be used at different stages of IBD to predict the disease course and/or to adapt treatment strategies. (C) 2010 Baishideng. All rights reserved.