潰瘍性結(jié)腸炎的病情評(píng)估2013

1、Evaluation and assessmentEvaluation and assessmentn Before starting treatment, patients need to be re-evaluated for correct diagnosis, and to ensure that other colitis and colonic lesions have been excluded. The anatomical location and extent of inflammation, severity and disease activity, presence

2、of extraintestinal manifestations and complications etc. should be scrutinized to decide the best form of treatment.n It is essential to remember that a correct diagnosis is based on the combination of clinical, endoscopic, radiological and histological data.n 2nd European evidence-based consensus o

3、n the diagnosis/management of ulcerative colitis 2012Clinical Subtypen 1、根據(jù)病程經(jīng)過n 初發(fā)型 慢性反復(fù)發(fā)作型 慢性持續(xù)型 急性爆發(fā)型(Acute fulminant colitis)n 初發(fā)型 慢性復(fù)發(fā)型n 2、根據(jù)病變部位和范圍n 直腸炎和直乙結(jié)腸炎 左半結(jié)腸炎 右半結(jié)腸炎 區(qū)域性結(jié)腸炎 全結(jié)腸炎 n 直腸炎 左半結(jié)腸炎 廣泛結(jié)腸炎n 3、根據(jù)病情n 輕度 中度 重度n 4、根據(jù)病情分期n 活動(dòng)期 緩解期炎癥性腸病診斷與治療的共識(shí)意見（2012年廣州）Truelove and Witts Severity Index

4、Truelove SC, Witts LJ. Cortisone in ulcerative colitis. Final report on a therapeutic trial. BMJ 1955;2:10411048.Montreal classification According to Disease ExtentSatsangi J，Silverberg MS，Vermeire S，et a1The Montreal classification of inflammatory bowel disease：controversies，consensus，and implicati

5、onsGut2006，55：749753Montreal classification According to Disease SeveritySatsangi J，Silverberg MS，Vermeire S，et a1The Montreal classification of inflammatory bowel disease：controversies，consensus，and implicationsGut2006，55：749753Sutherland IndexSutherland Index （DAIDAI）Mayo Scoren Sutherland IndexSu

6、therland Index (also called Mayo scores) (also called Mayo scores)n Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis, a randomized study. N Engl J Med 1987;317:16259.n Sutherland LR, Martin F, Greer S, et al. 5-Aminos

7、alicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis. Gastroenterology 1987;92:18948.Endoscopic scoresEndoscopic scoresStange EF，Travis SP，Vermeire S，et al，European evidence-based Consensus on the diagnosis and management of ulcerative colitis：definitio

8、ns and diagnosisJ Crohns Colitis，2008，2：123BaronBaron e endoscopic scoresndoscopic scoresBaron JHConnell AMLennard-Jones JEVariation between observers in describing mucosal appearances in proctocolitisBr Med J. 1964。1：8992Endoscopic scoresEndoscopic scores (UCEIS ) (UCEIS )Travis SP, Schnell D, Krze

9、ski P, AbreuMT, Altman DG, Colombel JF, et al. Developing an instrument to assess the endoscopic severity of ulcerative colitis: the Ulcerative Colitis Endoscopic Index of Severity (UCEIS). Gut 2012;61:53542.Histologic findingsn Truelove SC, Richards WC. Biopsy results in ulcerative colitis. Br Med

10、J. 1956;1:13151318.n Riley SA, Mani V, Goodman MJ, et al. Microscopic activity in ulcerative colitis: what does it mean? Gut. 1991;32:174178.n Geboes K, Riddell R, Ost A, et al. A reproducible grading scale for histological assessment of inflammation in UC. Gut. 2000;47: 404409.n Bitton A, Peppercor

11、n MA, Antonioli DA, et al. Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis. Gastroenterology. 2001;120:1320.n Thia KT, Loftus EVj, Pardi DS, et al. Measurement of disease activity in ulcerative colitis: Interobserver agreement and predictors of severity.