细胞因子与炎症性肠病

炎症性肠病目前认为是由多因素相互作用所致,主要包括免疫、环境以及遗传等因素,而由活化的免疫细胞产生的细胞因子,在IBD发病机制中起的作用,越来越引起人们关注。本文对常见的促炎细胞因子、抗炎细胞因子及具有免疫调节活性的细胞因子进行综述。     

炎症性肠病临床、病理及影像学诊断研究进展

随着生活节奏加快、环境因素影响和饮食结构的变化,我国炎症性肠病的发病率近年呈持续上升趋势.临床医生对该病的诊断主要依靠内镜病理,但其敏感性、特异性和病人顺应性不高.随着影像技术的快速发展,多种无创伤性的影像诊断方法 正在成为炎症性肠病筛查和诊断的重要手段,对内镜和病理诊断起到了协同、补充的作用.     

炎症性肠病的MRI进展

炎症性肠病（IBD）是一组病因不明的慢性炎症性肠病,包括克罗恩病（CD）和溃疡性结肠炎（UC）,常导致肠腔狭窄或穿透性肠损伤,其病程发展过程中需要经常评估疾病的活动性和并发症,以便制定正确的治疗方案。MRI软组织分辨力高,可以获得肠壁的动态信息,已应用于对IBD的检出、评估病变活动性、判断病变纤维化程度及鉴别CD与UC等。就MR小肠成像、扩散加权成像、动态增强MRI及磁化传递成像等在IBD中的应用进展予以综述。     

细菌与炎症性肠病

炎症性肠病（IBD）是一种病因尚不明确的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎（UC）和克罗恩病（CD）。此病可能的病因有由基因决定的宿主易患性、肠道细菌的作用、自身免疫、环境因素等。肠道细菌的感染因素作为一种主要病因,虽尚未被证实,但已有许多研究表明,细菌是IBD的促发因素。近年的研究表明,     

幽门螺杆菌感染与炎症性肠病相关性研究

目的探讨幽门螺杆菌感染与炎症性肠病的相关性。方法选取炎症性肠病患者52例作为炎症组,其中溃疡性结肠炎患者30例(溃疡性结肠炎组,包括全结肠受累18例与部分结肠受累12例)、Crohn病患者22例(Crohn病组);有消化道症状但肠镜检查正常者60例作为正常组。应用~(14)C尿素呼气试验检测炎症组与正常组幽门螺杆菌感染率。结果炎症组幽门螺杆菌感染率为19.2%(10/52),正常组为46.7%(28/60),炎症组明显低于正常组,差异有统计学意义(P<0.05)。溃疡性结肠炎组幽门螺杆菌感染率为20.0%(6/30),Crohn病组为18.2%(4/22),两组间比较,差异无统计学意义(P>0.05)。溃疡性结肠炎组中,全结肠受累患者幽门螺杆菌感染率为5.6%(1/18),部分结肠受累患者为41.7%(5/12),全结肠受累明显低于部分结肠受累,差异有统计学意义(P<0.05)。结论幽门螺杆菌感染可能预防炎症性肠病的发生与进展。     

肠道微生物对炎症性肠病影响研究进展

随着研究技术的不断发展,关于肠道微生物的研究越来越多。肠道微生物在炎症性肠病(inflammation bowel disease,IBD)的发病与发展中起到重要作用。IBD患者肠道微生物数量、种类和丰度均会发生变化,同时伴随其相应代谢产物变化,继而引起黏膜屏障受损、免疫和炎症反应,使部分肠内微生物和代谢物转移至循环中,引发微弱的全身炎症。     

炎症性肠病研究新进展

炎症性肠病（IBD）指溃疡性结肠炎（UC）和克罗恩病（CD）,该二种病均以慢性过程、自动复发、病因未明为其特征.西方国家发病率较高,国内发病有上升趋势,为此,中华医学会消化学会于1978（杭州）、1993（太原）和2000（成都）分别召开了炎症性肠病专项研讨会,对其病因、诊断和治疗的规范进行了讨论.     

蛋白组织学研究在炎症性肠病中的应用

炎症性肠病（inflammatory bowel disease,IBD）是一组病因未明的慢性非特异性肠道炎症性疾病．目前大多数学者将其归结为自身免疫性疾病,包括溃疡性结肠炎（Ulcerative colitis,UC）和克罗恩病（Crohn’s disease．CD）。两者发病的基本病理过程相似,但其发病部位及临床表现不全相同,前者常自远端结肠开始发病,逆行向近端发展。严重时甚至累及全结肠及末端回肠,主要累及肠黏膜及黏膜下层,属于慢性非特异性结肠炎;后者可累及胃肠道各部位,但以末端回肠及其邻近结肠受累最为常见,     

部队合理用药系列讲座（3） 炎症性肠病临床合理用药

炎症性肠病（IBD）是一种病因尚不明确的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎（UC）和克罗恩病（CD）。     

Hypertrophic osteoarthropathy of chronic inflammatory bowel disease

The case of a 14-year-old girl with painful periostitis and ulcerative colitis is reported. The association of chronic inflammatory bowel disease with osteoarthropathy is rare and has previously been reported in eight patients. The periosteal reaction found in association with inflammatory bowel disease is apparently related to a chronic disease course and may cause extreme localized pain.     

骨保护素在炎症性肠病中的临床应用

炎症性肠病(IBD)是一种慢性非特异性炎性疾病,发病机制目前仍不十分清楚,其诊断也是医学界的一大难题.骨保护素(OPG)是一种生长因子受体,在骨代谢中起着重要作用,且与细胞的增殖、分化、死亡等相关.研究发现OPG能反映IBD的病变程度、部位、类型,能预测溃疡性结肠炎(UC)患儿对糖皮质激素的敏感性,有望成为协助IBD诊断的新指标.本文就OPG参与IBD的发病机制以及OPG在临床上的应用做一综述.     

The impact of helical computed tomography on the diagnosis of unsuspected inflammatory bowel disease in the large bowel

Inflammatory bowel diseases (IBD) are diagnoses that can be easily overlooked clinically. The aim of this study was to investigate if CT is able to make a contribution to the identification of previously unsuspected cases of IBD. We retrospectively identified cases in which the possibility of an IBD was raised in CT reports (over a 4-year period), by utilising a keyword search of the radiology database. Cases with a previously known or suspected IBD were rigorously excluded by review of case notes, and endoscopic, radiological, histological and microbiological findings. The CT images of the identified cases were reviewed by a blinded observer to document the extent of bowel wall thickening, the location of lesion(s), and presence of peri-colic fat abnormality, ascites and/or collections. The observer also attempted to corroborate the presence, and to identify the type, of IBD based on the CT appearances alone. Thirty-five cases (out of approximately 19,000 body CTs performed) of clinically unsuspected IBD were identified, of which 27 underwent further investigation. An IBD was confirmed in 48% (13 of 27): Crohn's disease (n=6), ulcerative colitis (n=2), pseudomembranous colitis (n=3) and other (n=2), of which 70% (9 of 13) were correctly typed by the reviewer. Inflammatory bowel disease was not substantiated in the remainder (14 of 27), although 7 of these had other bowel pathologies: diverticular disease (n=4); and carcinoma (n=3). Prospectively determining the presence, and furthermore type, of IBD on CT is challenging largely because of the considerable overlap in the appearances of the individual IBDs and indeed of normality. Nevertheless, CT is able to identify clinically unsuspected cases and radiologists should be alert to this treatable and not infrequently elusive diagnosis. Electronic Publication     

Ultrasonography of chronic inflammatory bowel diseases

Advances in the understanding of bowel appearances with high-resolution sonography have led to consideration of this technique as an important tool for bowel disease assessment. Ultrasonography may display the transformation of the intestinal wall from normal to pathological state in inflammatory diseases. Furthermore, intestinal ultrasonography may serve as a diagnostic clue if typical patterns of the bowel wall are demonstrated. Thus, Crohn's disease, ulcerative colitis, diverticulitis, or infectious ileocolitis may be specifically demonstrated in the majority of cases. Besides showing the parietal signs of inflammation, ultrasonography also shows the perigut abnormalities and may demonstrate complications such as fistulas and abscesses. Finally, with the help of Doppler, some additional information may be obtained about the activity of chronic inflammatory diseases. In clinical practice, used in combination with other imaging modalities, such as CT or endoscopy, bowel ultrasonography appears to be a non-invasive and effective diagnostic tool for the diagnosis and follow-up of Crohn's disease and ulcerative colitis. Electronic Publication     

Advanced multimodality imaging of inflammatory bowel disease in 2015: An update

The diagnosis and effective management of inflammatory bowel disease (IBD) requires a combination clinical, endoscopic, histological, biological, and imaging data. While endoscopy and biopsy remains the gold standard for diagnosis of IBD, imaging plays a central role in the assessment of extra mural disease, in disease surveillance and in the assessment of response to medical treatments, which are often expensive. Imaging is also vital in the detection and diagnosis of disease related complications, both acute and chronic. In this review, we will describe, with illustrative images, the imaging features of IBD in adults, with emphasis on up-to-date imaging techniques focusing predominantly on cross sectional imaging and new magnetic resonance imaging techniques.     

白介素-17在幼年大鼠炎症性肠病中表达及意义

目的探讨白介素-17(IL-17)在炎症性肠病(IBD)幼年大鼠中的表达及其在临床中的意义。方法将16只SD大鼠随机分成DSS模型组和空白对照组2组,每组8只。利用葡聚糖硫酸钠(DSS)诱导大鼠IBD模型,观察其一般状况,计算疾病活动指数(DAI)评分。在第8天处死所有大鼠,取病变结肠病理切片,观察病理改变,并采用免疫组化法检测肠黏膜局部IL-17的表达。结果 DSS模型组DAI评分明显高于空白对照组,病理显示肠道炎症损伤明显,肠黏膜中可见大量炎细胞浸润,腺体结构破坏明显。免疫组化研究显示,DSS模型组肠黏膜中IL-17细胞因子的表达高于空白对照组,差异有统计学意义(P<0.05)。结论炎症性肠病幼年大鼠结肠组织中IL-17水平升高,提示IL-17在儿童炎症性肠病的发生中可能起到重要作用。