Tom 15, Nr 1 (2023)
Artykuł przeglądowy
Opublikowany online: 2024-05-28
Wyświetlenia strony
223
Wyświetlenia/pobrania artykułu
15
Monitorowanie pacjentów z czynną chorobą zapalną jelit
DOI: 10.5603/gek.100659
Gastroenterologia Kliniczna 2023;15(1):50-67.
Streszczenie
W erze leczenia prowadzonego do uzyskania celu terapeutycznego coraz większego znaczenia nabiera ścisłe monitorowanie pacjentów z chorobą zapalną jelit (IBD). Nie można pomijać parametrów skuteczności leczenia ocenianych przez pacjenta (PROM), jednak ich ograniczone związek z parametrami biochemicznymi, histologicznymi i endoskopowymi podkreśla potrzebę opracowania dodatkowych strategii monitorowania. Remisja endoskopowa i histologiczna wiąże się z lepszymi wynikami długoterminowymi, ale wymaga bardziej inwazyjnych metod oceny. W związku z tym coraz bardziej istotne stają się nieinwazyjne metody monitorowania, a coraz więcej dowodów wskazuje na dodatkową wartość kliniczną oceny przezściennej, zarówno u pacjentów z chorobą Leśniowskiego-Crohna, jak i wrzodziejącym zapaleniem jelita grubego. W niniejszym przeglądzie przedstawiono wiele celów terapeutycznych w leczeniu pacjentów z IBD, koncentrując się w szczególności na coraz większym znaczeniu ultrasonografii jelit. Zaproponowano też możliwy algorytm monitorowania pacjentów z IBD w codziennej praktyce klinicznej i wskazano obszary, które należy uwzględnić w przyszłych badaniach dotyczących strategii monitorowania pacjentów z IBD.
Słowa kluczowe: monitorowanieultrasonografia jelitchoroba zapalna jelit (IBD)enterografia rezonansu magnetycznego (MRE)biomarkergojenie przezściennegojenie błony śluzowej (MH)remisja endoskopowa (ER)
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