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溃疡性结肠炎

溃疡性结肠炎
Ulcerative colitis
患有溃疡性结肠炎的结肠,结肠镜检查的影像。结肠的内表面有斑点,也有破损
症状腹痛腹泻且带血、体重下降发热贫血[1]
并发症巨结肠症英语Megacolon、眼睛、关节或是肝脏发炎、大肠癌[1][2]
起病年龄15–30岁或是60岁以上[1]
病程长期[1]
病因不明[1]
诊断方法结肠镜英语Colonoscopy以及活体组织切片[1]
鉴别诊断痢疾克隆氏症缺血性结肠炎英语ischemic colitis[3]
治疗调整饮食、药物、手术[1]
药物柳氮磺胺吡啶美沙拉嗪皮质类固醇、像是硫唑嘌呤之类的免疫抑制剂、生物疗法英语Biological therapy for inflammatory bowel disease[1]
患病率每一千人最多5人[4]
死亡数2015年和克隆氏症共造成47,400人死亡[5]
分类和外部资源
医学专科胃肠学
ICD-11DD71
ICD-9-CM556、​556.9、​556.5、​556.8
OMIM191390
DiseasesDB13495
MedlinePlus000250
eMedicine183084
Orphanet771
[编辑此条目的维基数据]

溃疡性结肠炎(英语:ulcerative colitis,缩写作 UC),也称非特异性溃疡性结肠炎,是一种会导致结肠直肠发炎溃疡慢性疾病[1][6]。病变通常起源于直肠,持续到结肠近端,并且通常局限于粘膜层。[7][8]其发作时的主要症状包括腹痛与伴有血便的腹泻[1]体重减轻发热以及贫血的症状也有可能在溃疡性结肠炎发作时出现[1]。通常其症状发生的进程缓慢,且会轻重不一[1],其症状表现常间歇出现,两次发作中间常伴随有一段无症状期[1]。溃疡性结肠炎的并发症可能包括巨结肠症英语Megacolon或眼部、关节或肝脏的炎症,以及结肠癌[1][2]。世界卫生组织已将UC列为严重威胁人类健康的难治性疾病。[9]

溃疡性结肠炎的病因并不明确[1]。与其病因相关的理论有自体免疫性疾病遗传学肠道菌群的改变,以及环境因素[1][10]。对于发达国家之罹病率较高,部分提出的论点为:缺少接触感染原的卫生假说西方饮食习惯英语Western pattern diet的引进及生活方式的差异等[6][11]。早期将阑尾去除,可能有一定的预防作用[11]。典型的诊断方式为结肠镜检查搭配活体组织切片[1]。溃疡性结肠炎是一种伴随着克隆氏症显微镜下结肠炎英语Microscopic colitis炎症性肠病[1]

饮食习性的改变有助于改善症状,例如高热量饮食或是无乳糖饮食[1]。几种药物常用于治疗症状,或是缓解症状,包含氨基水杨酸盐英语Aminosalicylate如:柳氮磺胺吡啶皮质类固醇免疫抑制剂如:硫唑嘌呤炎症性肠炎的生物疗法英语Biological therapy for inflammatory bowel disease[1]。若病情严重、治疗后不见改善、或是出现像大肠癌之类的并发症,需进行 结肠切除术英语Colectom[1]直肠结肠切除术英语Proctocolectomy可以根治此一疾病[1][11]

截至2015年,约有一千一百万人受到溃疡性结肠炎与与克隆氏症共同影响[12]。每年新发生人数每10万人中约1至20人,每10万人中有5至500人受到影响[6][11]。此疾病在北美和欧洲比其他地区更常见[11]。通常发生于15至30岁的人,或60岁以上的人[1]。男性和女性似乎受影响的比例相同[6],自1950年代以来,此疾病越来越普遍[6][11]。溃疡性结肠炎和克隆氏症共同影响约100万美国人[13]。若经过适当治疗,死亡风险与常人相同[2]。溃疡性结肠炎的第一次描述在1850年左右[11]

著名患者

参考文献

  1. ^ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 1.16 1.17 1.18 1.19 1.20 1.21 1.22 Ulcerative Colitis. NIDDK. September 2014 [3 August 2016]. (原始内容存档于2016-07-28). 
  2. ^ 2.0 2.1 2.2 Wanderås, Magnus Hofrenning; Moum, Bjørn A; Høivik, Marte Lie; Hovde, Øistein. Predictive factors for a severe clinical course in ulcerative colitis: Results from population-based studies. World Journal of Gastrointestinal Pharmacology and Therapeutics. 2016-05-06, 7 (2): 235–241. ISSN 2150-5349. PMC 4848246可免费查阅. PMID 27158539. doi:10.4292/wjgpt.v7.i2.235. 
  3. ^ Runge, Marschall S.; Greganti, M. Andrew. Netter's Internal Medicine E-Book. Elsevier Health Sciences. 2008: 428 [2018-04-20]. ISBN 9781437727722. (原始内容存档于2018-04-09) (英语). 
  4. ^ Molodecky, NA; Soon, IS; Rabi, DM; Ghali, WA; Ferris, M; Chernoff, G; Benchimol, EI; Panaccione, R; Ghosh, S; Barkema, HW; Kaplan, GG. Increasing incidence and prevalence of the inflammatory bowel diseases with time, based on systematic review.. Gastroenterology. January 2012, 142 (1): 46–54.e42; quiz e30. PMID 22001864. doi:10.1053/j.gastro.2011.10.001. 
  5. ^ GBD 2015 Mortality and Causes of Death, Collaborators. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 8 October 2016, 388 (10053): 1459–1544. PMC 5388903可免费查阅. PMID 27733281. doi:10.1016/s0140-6736(16)31012-1. 
  6. ^ 6.0 6.1 6.2 6.3 6.4 Ford, AC; Moayyedi, P; Hanauer, SB. Ulcerative colitis.. BMJ (Clinical research ed.). 5 February 2013, 346: f432. PMID 23386404. doi:10.1136/bmj.f432. 
  7. ^ Nakase, Hiroshi; Uchino, Motoi; Shinzaki, Shinichiro; Matsuura, Minoru; Matsuoka, Katsuyoshi; Kobayashi, Taku; Saruta, Masayuki; Hirai, Fumihito; Hata, Keisuke; Hiraoka, Sakiko; Esaki, Motohiro. Evidence-based clinical practice guidelines for inflammatory bowel disease 2020. Journal of Gastroenterology. 2021-06, 56 (6). ISSN 0944-1174. PMC 8137635可免费查阅. PMID 33885977. doi:10.1007/s00535-021-01784-1 (英语). 
  8. ^ Rubin, David T.; Ananthakrishnan, Ashwin N.; Siegel, Corey A.; Sauer, Bryan G.; Long, Millie D. ACG Clinical Guideline: Ulcerative Colitis in Adults. American Journal of Gastroenterology. 2019-03, 114 (3). ISSN 0002-9270. doi:10.14309/ajg.0000000000000152 (英语). 
  9. ^ Ng, Siew C; Shi, Hai Yun; Hamidi, Nima; Underwood, Fox E; Tang, Whitney; Benchimol, Eric I; Panaccione, Remo; Ghosh, Subrata; Wu, Justin C Y; Chan, Francis K L; Sung, Joseph J Y. Worldwide incidence and prevalence of inflammatory bowel disease in the 21st century: a systematic review of population-based studies. The Lancet. 2017-12, 390 (10114) [2024-01-25]. doi:10.1016/S0140-6736(17)32448-0. (原始内容存档于2024-02-11) (英语). 
  10. ^ Akiho, Hirotada; Yokoyama, Azusa; Abe, Shuichi; Nakazono, Yuichi; Murakami, Masatoshi; Otsuka, Yoshihiro; Fukawa, Kyoko; Esaki, Mitsuru; Niina, Yusuke. Promising biological therapies for ulcerative colitis: A review of the literature. World Journal of Gastrointestinal Pathophysiology. 2015-11-15, 6 (4): 219–227. ISSN 2150-5330. PMC 4644886可免费查阅. PMID 26600980. doi:10.4291/wjgp.v6.i4.219. 
  11. ^ 11.0 11.1 11.2 11.3 11.4 11.5 11.6 Danese, S; Fiocchi, C. Ulcerative colitis.. The New England Journal of Medicine. 3 November 2011, 365 (18): 1713–25. PMID 22047562. doi:10.1056/NEJMra1102942. 
  12. ^ GBD 2015 Disease and Injury Incidence and Prevalence, Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015.. Lancet. 8 October 2016, 388 (10053): 1545–1602. PMC 5055577可免费查阅. PMID 27733282. doi:10.1016/S0140-6736(16)31678-6. 
  13. ^ Adams, James G. Emergency Medicine E-Book: Clinical Essentials (Expert Consult -- Online). Elsevier Health Sciences. 2012: 304 [2018-04-20]. ISBN 1455733946. (原始内容存档于2020-03-16) (英语). 

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溃疡性结肠炎
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