溃疡性结肠炎的共识意见

溃疡性结肠炎的共识意见第1页/共11页溃疡性结肠炎的共识意见第2页/共11页ConsensusStangeEF,TravisSP,VermeireS,ReinischW,GeboesK,BarakauskieneA,etal.Europeanevidence-basedConsensusonthediagnosisandmanagementofulcerativecolitis:definitionsanddiagnosis.JCrohnsColitis2008;2:1–23.VanAsscheG，DignassA，PanesJ，eta1．ThesecondEuropeanevidence-basedConsensusonthediagnosisandmanagementofulcerativecolitis：Definitionsanddiagnosis．JCrohnsColitis，2010·4：727．MowatC,ColeA,WindsorA,AhmadT,ArnottI,DriscollR,etal.Guidelinesforthemanagementofinflammatoryboweldiseaseinadults.Gut2011;60:571–607.TurnerD,LevineA,EscherJC,GriffithsAM,RussellRK,DignassA,etal.Managementofpediatriculcerativecolitis:ajointECCOandESPGHANevidence-basedconsensusguidelines.JPediatrGastroenterolNutr2012.TurnerD,TravisSP,GriffithsAM,RuemmeleFM,LevineA,BenchimolEI,etal.Consensusformanagingacutesevereulcerativecolitisinchildren:asystematicreviewandjointstatementfromECCO,ESPGHAN,andthePortoIBDWorkingGroupofESPGHAN.AmJGastroenterol2011;106:574–88.第3页/共11页Managementconsensusofinflammatoryboweldiseasefor

theAsia–Pacificregion2006

Abstract:Atthepresenttherearenolarge-scaleepidemiologicdataoninflammatoryboweldisease(IBD)intheAsia–Pacificregion,butseveralstudieshaveshownanincreasedincidenceandprevalenceofIBDinthisregion.ComparedtotheWest,thereappearstoexistatimelagphenomenon.WithregardtothetwomainformsofIBD,ulcerativecolitis(UC)ismoreprevalentthanCrohn’sdisease(CD).Inadditiontogeographicdifferences,ethnicdifferenceshavebeenobservedinthemultiracialAsiancountries.Moreover,thegeneticbackgroundsaredifferentintheAsiancomparedtoWesternpatients.Forinstance,NOD2/CARD15variantshavenotbeenfoundinAsianCDpatients.Ingeneral,theclinicalcourseofIBDseemstobelesssevereintheAsia–PacificregionthaninWesterncountries.DiagnosisofIBDinthisregionposesspecialproblems.ThelackofagoldstandardforthediagnosisofIBD,andtheexistenceofavarietyofinfectiousenterocolitiswithsimilarmanifestationstothoseofIBDmakethedifferentialdiagnosisparticularlydifficult.Sofar,WesterndiagnosticcriteriahavebeenintroducedforthediagnosisofIBD.Astepwiseapproachtoexcludenon-IBDenterocolitisalsomustbeintroduced,andadefinitediagnosismustincludetypicalhistologicalfeatures.Insomepatients,followupandtherapeutictrialsmightbenecessarytoobtainadefinitivediagnosis.AbetterunderstandingofthepathogenesisofIBDwillallowthedevelopmentofbetterdiagnosticmarkers.ThemanagementofIBDalsoposessomespecialproblemsintheAsia–PacificRegion.ThereisoftenadelayinusingpropermedicationsforIBD,andalternativelocalremediesarestillwidelyused.WithacombinationofWesternguidelinesandregionalexperiences,similarprinciplescanbeusedforinductionandmaintenanceofremission.Astepwiseselectionofmedicationsisadvocateddependingontheextent,activityandseverityofthedisease.ComprehensiveandindividualizedapproachesaresuggestedfordifferentIBDpatients.DeeperunderstandingofdiseasepathogenesisandtheuniquecharacteristicsofIBDintheAsia–Pacificregion,combinedwithreasonableandpracticalguidelinesfordrugmanagementandthefutureuseofbiologicalagentswouldimprovethetherapeuticoutlookofIBDinthisregion.第4页/共11页TheAsia-Pacificconsensusonulcerativecolitis2010

第5页/共11页Europeanevidence-basedconsensusonthediagnosis/managementofulcerativecolitis2008ThisdocumentsetsoutthecurrentEuropeanConsensusonthediagnosisandmanagementofUC,reachedbytheEuropeanCrohn'sandColitisOrganisation(ECCO)atameetingheldinBerlinon20thOctober2006.ECCOisaforumforspecialistsininflammatoryboweldiseasefrom23Europeancountries.LiketheinitialConsensusonthemanagementofCrohn'sdisease,thecurrentConsensusisgroupedintothreeparts:definitionsanddiagnosis;currentmanagement;andmanagementofspecialsituations.Thisfirstsectionconcernsaims,methodsanddefinitionsoftheConsensus,aswellasclassification,diagnosis,imagingandpathologyofUC.Thesecondsectiononcurrentmanagementincludestreatmentofactivedisease,maintenanceofmedically-inducedremissionandsurgeryofUC.Thethirdsectiononspecialsituationsincludespouchdisorders,cancersurveillance,pregnancy,paediatrics,psychosomatics,extra-intestinalmanifestationsandalternativetherapy.第6页/共11页2ndEuropeanevidence-basedconsensusonthediagnosis/managementofulcerativecolitis2012ThisdocumentupdatesthepreviousEuropeanConsensusonthediagnosisandmanagementofUC,andwasfinalisedbytheEuropeanCrohn'sandColitisOrganisation(ECCO)atameetingheldinDublininFebruary2011.ECCOisaforumforspecialistsininflammatoryboweldiseasefrom31Europeancountries.LiketheinitialConsensusonthediagnosisandmanagementofulcerativecolitis,6–8thisupdatedConsensusisgroupedintothreeparts:definitionsanddiagnosis;currentmanagement;andmanagementofspecialsituations.Previouslyincludedchaptersonpregnancyandpediatricsarenolongerincludedinthisguideline,asspecificECCOConsensusGuidelinesonReproductionandPregnancyandPediatricUC(togetherwithESPGHAN)coverthesetopicsextensively.第7页/共11页UlcerativecolitisinChina:Retrospectiveanalysisof3100

hospitalizedpatientsBackground&Aims:Thisretrospectivestudyanalyzedtheclinicalcharacteristicsofhospitalizedpatientswithulcerativecolitis(UC)inChina.Methods:Atotalof3100hospitalizedpatientswithUCadmittedto23hospitalsinChinafrom1990to2003wereretrospectivelyinvestigatedandtheirclinicalcharacteristicswereanalyzed.Results:Amale/femaleratioof1.34/1.00wasfoundinthe3100patients,whohadanaverageageof4415.1yearsatdiagnosis.Ofthepatients,2972(95.9%)hadactiveUC.ActiveUCwasmildin35.4%ofthe2972patients,moderatein42.9%andseverein21.7%.Ofthe2726patientswithadescriptionoftheirlesionextent,14.8%hadproctitis,26.4%hadproctosigmoiditis,25.0%hadleft-sidedcolitis,6.3%hadextensivecolitis,25.8%hadpancolitisand1.7%hadregionalcolitis.ThepredominantcomplaintsofthepatientswithUCwerebloodydiarrhea(48.2%),abdominalpain(67.3%)andmucusstools(58.4%).Amongthesepatients,13.6%hadextraintestinalmanifestationsand9.6%hadrelatedcomplications.Adifferentialdiagnosiswasdifficulttomake,astherewere19varietiesofthedisease;infectiousenterocolitishadamisdiagnosisrateof22.9%beforeadmission.ThemainmedicationsforUCinChinawereaminosalicylates(66.8%)andsteroids(42.8%).Only94(3%)ofthepatientsrequiredcolectomyandonly19(0.6%)diedofUC.Conclusions:ComparedwithUCinWesterncountries,ulcerativecolitisinChinahassomedifferencesinclinicalcharacteristics.Therefore,afurtherpopulati