溃疡性结肠炎临床治疗的研究进展

RESEARCH PROGRESS IN CLINICAL TREATMENT OF ULCERATIVE COLITIS

溃疡性结肠炎(ulcerative colitis,UC)是一种反复发作侵袭结直肠的慢性非特异性炎症。其发病机制是多因素的,包括遗传易感性、上皮屏障缺陷、免疫反应失调和环境因素。溃疡性结肠炎病变范围广,通常发生于直肠、降结肠,甚至可以延伸到整个结肠。主要症状为腹痛、腹泻及黏液脓血便,结肠镜检查和组织病理学检查可诊断。治疗的目的是诱导并维持缓解,即症状的消失和内窥镜下病变的愈合。而目前,随着UC的治疗手段正在扩大,未来几年,生物制剂以及具有新靶点的药物数量将迅速增加。一些非药物治疗,例如粪菌移植、白细胞吸附治疗等也逐渐被认知。对于一些重度UC,包括癌症、癌症风险(不典型增生)、狭窄、药物治疗无效等也可以手术治疗。本文就现有UC常见的治疗方案进行综述。

Ulcerative colitis(UC) is a chronic, nonspecific inflammation that attacks the colorectum repeatedly.The pathogenesis is multifactorial, including genetic susceptibility, epithelial barrier defects, immune response disorders, and environmental factors.Ulcerative colitis has a wide range of lesions, usually occurring in the rectum, descending colon, and may extend throughout the colon.The main symptoms were abdominal pain, diarrhea and mucous pus and blood stools, which could be diagnosed by colonoscopy and histopathological examination.The goal of treatment is to induce and maintain remission, i.e. absence of symptoms and endoscopic healing of the lesion.Now, as the treatment options for UC are expanding, the number of biologics and drugs with new targets will increase rapidly in the coming years.Some non-pharmacological treatments, such as faecal bacteria transplantation and leukocyte adsorption therapy, have also been gradually recognized.For some severe UC, including cancer, cancer risk(atypical hyperplasia), stenosis, and failure to respond to drug therapy, surgical treatment can also be performed.This article reviews the existing common treatment plans for UC.