课件：溃疡性结肠炎的病情评估.ppt

溃疡性结肠炎的病情评估,Evaluation and assessment,Before starting treatment, patients need to be re-evaluated for correct diagnosis, and to ensure that other colitis and colonic lesions have been excluded. The anatomical location and extent of inflammation, severity and disease activity, presence of extraintestinal manifestations and complications etc. should be scrutinized to decide the best form of treatment. It is essential to remember that a correct diagnosis is based on the combination of clinical, endoscopic, radiological and histological data. 2nd European evidence-based consensus on the diagnosis/management of ulcerative colitis 2012,Clinical Subtype,1、根据病程经过 初发型 慢性反复发作型 慢性持续型 急性爆发型(Acute fulminant colitis) 初发型 慢性复发型 2、根据病变部位和范围 直肠炎和直乙结肠炎 左半结肠炎 右半结肠炎 区域性结肠炎 全结肠炎 直肠炎 左半结肠炎 广泛结肠炎 3、根据病情 轻度 中度 重度 4、根据病情分期 活动期 缓解期,炎症性肠病诊断与治疗的共识意见（2012年广州）,Truelove and Witts Severity Index,Truelove SC, Witts LJ. Cortisone in ulcerative colitis. Final report on a therapeutic trial. BMJ 1955;2:10411048.,Montreal classification According to Disease Extent,Satsangi J，Silverberg MS，Vermeire S，et a1The Montreal classification of inflammatory bowel disease：controversies，consensus，and implicationsGut2006，55：749753,Montreal classification According to Disease Severity,Satsangi J，Silverberg MS，Vermeire S，et a1The Montreal classification of inflammatory bowel disease：controversies，consensus，and implicationsGut2006，55：749753,Sutherland Index （DAI）,Mayo Score,2019/8/21,9,可编辑,Sutherland Index (also called Mayo scores),Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis, a randomized study. N Engl J Med 1987;317:16259. Sutherland LR, Martin F, Greer S, et al. 5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis. Gastroenterology 1987;92:18948.,Endoscopic scores,Stange EF，Travis SP，Vermeire S，et al，European evidence-based Consensus on the diagnosis and management of ulcerative colitis：definitions and diagnosisJ Crohns Colitis，2008，2：123,Baron endoscopic scores,Baron JHConnell AMLennard-Jones JEVariation between observers in describing mucosal appearances in proctocolitisBr Med J. 1964。1：8992,Endoscopic scores (UCEIS ),Travis SP, Schnell D, Krzeski P, AbreuMT, Altman DG, Colombel JF, et al. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut 2012;61:53542.,Histologic findings,Truelove SC, Richards WC. Biopsy results in ulcerative colitis. Br Med J. 1956;1:13151318. Riley SA, Mani V, Goodman MJ, et al. Microscopic activity in ulcerative colitis: what does it mean? Gut. 1991;32:174178. Geboes K, Riddell R, Ost A, et al. A reproducible grading scale for histological assessment of inflammation in UC. Gut. 2000;47: 404409. Bitton A, Peppercorn MA, Antonioli DA, et al. Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis. Gastroenterology. 2001;120:1320. Thia KT, Loftus EVj, Pardi DS, et al. Measurement of disease activity in ulcerative colitis: Interobserver agreement and predictors of severity. Inflamm Bowel Dis 2010