肠型白塞病的诊断和治疗进展

Advances in diagnosis and treatment of intestinal Behcet′s disease

白塞病累及胃肠道者称为肠型白塞病。肠型白塞病的诊断和治疗目前仍缺少特异性检查方法及系统有效的治疗方案。其诊断及鉴别诊断主要依靠内镜及活组织检查，以静脉氨基水杨酸制剂和糖皮质激素为一线治疗方案，糖皮质激素抵抗者可以使用免疫抑制剂或英夫利昔单抗作为二线治疗方案。在治疗过程中需反复仔细评估病情，慎行外科手术治疗，而一旦发生严重并发症应及时转行外科手术治疗。本文就近年来国内外有关肠型白塞病的临床特点、诊断、鉴别诊断及治疗作一综述，以期为临床诊治提供参考。

Behcet′s disease （BD） affects gastrointestinal tract is defined as intestinal BD. The diagnosis and therapeutic efficacy of intestinal BD are still lack of specific diagnostic method and effective treatment. Intestinal BD is diagnosed according to established criteria based on colonoscopic features and biopsy. To date, 5-aminosalicylic acid and systemic corticosteroids are established as the first-line therapy, while immunosuppressants and infliximab are used as second-line therapy for patients with glucocorticoid resistant. In the process of therapy, we need to carefully evaluate the patient′s condition and be cautious about surgical treatment. Surgical intervention should only be considered in patients with serious complications. In this review, we summarize the recent advances in diagnosis, disease activity index and treatment of intestinal BD, and provide the theoretic proofs to clinical application.