溃疡性结肠炎的病情评估PPT课件.ppt

溃疡性结肠炎的病情评估 Evaluationandassessment Beforestartingtreatment patientsneedtobere evaluatedforcorrectdiagnosis andtoensurethatothercolitisandcoloniclesionshavebeenexcluded Theanatomicallocationandextentofinflammation severityanddiseaseactivity presenceofextraintestinalmanifestationsandcomplicationsetc shouldbescrutinizedtodecidethebestformoftreatment Itisessentialtorememberthatacorrectdiagnosisisbasedonthecombinationofclinical endoscopic radiologicalandhistologicaldata 2ndEuropeanevidence basedconsensusonthediagnosis managementofulcerativecolitis2012 ClinicalSubtype 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 Acutefulminantcolitis 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 TrueloveandWittsSeverityIndex TrueloveSC WittsLJ Cortisoneinulcerativecolitis Finalreportonatherapeutictrial BMJ1955 2 1041 1048 MontrealclassificationAccordingtoDiseaseExtent SatsangiJ SilverbergMS VermeireS eta1 TheMontrealclassificationofinflammatoryboweldisease controversies consensus andimplications Gut 2006 55 749 753 MontrealclassificationAccordingtoDiseaseSeverity SatsangiJ SilverbergMS VermeireS eta1 TheMontrealclassificationofinflammatoryboweldisease controversies consensus andimplications Gut 2006 55 749 753 SutherlandIndex DAI MayoScore 2020 1 27 9 SutherlandIndex alsocalledMayoscores SchroederKW TremaineWJ IlstrupDM Coatedoral5 aminosalicylicacidtherapyformildlytomoderatelyactiveulcerativecolitis arandomizedstudy NEnglJMed1987 317 1625 9 SutherlandLR MartinF GreerS etal 5 Aminosalicylicacidenemainthetreatmentofdistalulcerativecolitis proctosigmoiditis andproctitis Gastroenterology1987 92 1894 8 Endoscopicscores StangeEF TravisSP VermeireS etal Europeanevidence basedConsensusonthediagnosisandmanagementofulcerativecolitis definitionsanddiagnosis JCrohnsColitis 2008 2 1 23 Baronendoscopicscores BaronJH ConnellAM Lennard JonesJE Variationbetweenobserversindescribingmucosalappearancesinproctocolitis BrMedJ 1964 1 89 92 Endoscopicscores UCEIS TravisSP SchnellD KrzeskiP AbreuMT AltmanDG ColombelJF etal Developinganinstrumenttoassesstheendoscopicseverityofulcerativecolitis theUlcerativeColitisEndoscopicIndexofSeverity UCEIS Gut2012 61 535 42 Histologicfindings TrueloveSC RichardsWC Biopsyresultsinulcerativecolitis BrMedJ 1956 1 1315 1318 RileySA ManiV GoodmanMJ etal Microscopicactivityinulcerativecolitis whatdoesitmean Gut 1991 32 174 178 GeboesK RiddellR OstA etal AreproduciblegradingscaleforhistologicalassessmentofinflammationinUC Gut 2000 47 404 409 BittonA PeppercornMA AntonioliDA etal Clinical biological andhistologicparametersaspredictorsofrelapseinulcerativecolitis Gastroenterology 2001 120 13 20 ThiaKT LoftusEVj PardiDS etal Measurementofdiseaseactivityinulcerativecolitis Interobserveragreementandpredictorsofseverity InflammBowelDi