溃疡性结肠炎的研究进展2013.ppt

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1、溃疡性结肠炎的研究进展IntroductionIBD是一种病因尚不十分清楚的慢性非特异性肠道炎症，包括UC和CD。其发病率呈逐年上升趋势，且多为青壮年发病，临床表现复杂，并发症严重，肠外表现多样，严重影响个人生活质量和社会生产力。此外，因其有癌变的风险，备受广大医生的重视。近年来在国内外IBD基础与临床研究高潮迭起，基础研究的成果直接指向临床治疗，取得了划时代的进展。探讨和摸索适合国人的治疗方案以降低重症UC的并发症和死亡率显得十分重要。EpidemiolgyTheincidenceofUCrang

2、edfrom1.0to2.0per100000personyears.TheprevalenceofUChasrangedfrom4.0to44.3per100000.Inarecentstudy,thespeculatedprevalencewas11.6/100000inChina.ComparedtotimetrendsintheWest,thereappearstobeatimelagphenomenoninvolvingincidenceandandprevalenceofIBDwithr

3、egardtotheAsianexperience.OuyangQ,TandonR,GohKLetal.ManagementconsensusofinflammatoryboweldiseasefortheAsia-Pacificregion.JGastroenterol.Hepatol.2006;21:1772–82.Lennrd-JonesJE.IncidenceofinfammatoryboweldiseaseacrossEurope:isthereadifferencebetweennort

4、handsouth?.Gut1996;39:690-697.EtiologyandPathogenesis目前对IBD病因和发病机制的认识可概括为：环境因素作用于遗传易感者，在肠道菌群丛的参与下，启动了肠道免疫系统及非免疫系统，最终导致免疫反应和炎症过程。可能是由于抗原的持续刺激或（及）免疫调节紊乱，这种免疫炎症反应表现为过度亢进或难于自限。BaumgartDC,CardingSR.Inflammatoryboweldisease:causeandimmunobiology.Lancet2007;3

5、69:1627–1640.BrownSJ，MayerI．Theimmuneresponseininflammatoryboweldisease．AmJGastroenterol，2007，102：2058—2069．BernsteinCN，ShanahanF．Disordersofamodernlifestylelreconcilingtheepidemiologyofinflammatoryboweldiseases．Gut，2008，57：1185-1191．FamilyhistoryKitah

6、oraetal.foundastrongfamilialoccurrenceinUCamongJapanesepatients.InaKoreanstudy,asimilarfamilialaggregationwasalsoreported.KitahoraT,UtsunomiyaT,YokotaA.EpidemiologicalstudyofulcerativecolitisinJapan:incidenceandfamilialoccurrence.TheEpidemiologyGroupof

7、theResearchCommitteeofInflammatoryBowelDiseaseinJapan.J.Gastroenterol.1995;30(Suppl.8):5–8.ParkER,YangSK,MyungSJetal.FamilialoccurrenceofulcerativecolitisinKorea.KoreanJ.Gastroenterol.2000;36:770–4.RiskfactorsObjectiveToscreentheriskfactorsofinflammato

8、ryboweldisease(IBD)bycaseinvestigation．Methords72determinedIBDpatientsand72pairedhealthysubjectsweresurveyedwithanorganizedinventorycomprisingofrelevantitemstoIBD．COXregressionmethodwasusedtoscreenthestatisticallysignificantriskfactorsf