炎症性肠病治疗的理想目标:深度缓解的意义和对策

Goal of treatment of inflammatory bowel disease: Deep remission and therapeutic strategies

炎症性肠病(inflammatory bowel disease,I B D)是一种慢性非特异性肠道炎症性疾病,其病因不明确,可能是遗传因素、环境因素、免疫反应异常等多因素共同作用的结果.目前传统治疗药物有氨基水杨酸制剂、糖皮质激素、免疫抑制剂等,及生物制剂如抗肿瘤坏死因子-?.现阶段治疗多数以改善症状和达到临床缓解为治疗终点,随着对治疗后的预后的观察研究,发现仅仅达到临床缓解,并不能完全改变IBD的整体预后,仍易发生各种并发症,严重影响生活质量,甚至危及生命,同时也不断增加患者经济负担.因此,我们的治疗目标终点已经从临床症状改善和临床缓解(clinical response and remission)提升到黏膜愈合(mucosal healing),再到追求深度缓解(deep remission).本文就深度缓解的概念、意义及对策进行阐述.

Inflammatory bowel disease（IBD） is a nonspecific chronic inflammatory disorder of the gut. Although its etiology remains unclear, it maybe involves the interactions among geneticfactors, environmental factors and inappropriate immune response. Conventional therapies for IBD include aminosalicylates, corticosteroids, immunosuppressants, and anti-tumor necrosis factor agents. Increasing recognition of the concept of quality of life has led to the evolution of treatment goals in IBD from clinical response and remission toward deep remission. This paper highlights the def inition and importance of deep remission, and the current strategies to achieve deep remission.