溃疡性结肠炎Ulcerativecolitis.pptVIP

Inflammatory Bowel Disease (IBD) Is a generic term that refers to idiopathic chronic inflammatory disease of the intestine. Ulcerative Colitis (UC) Crohn Disease (CD) Etiology and pathogenesis The cause of IBD is unknown, Several possibilities as below: Environmental factors Genetic factors Infective factors Disturbance of immunity 1. Environmental factors Increasing worldwide in recent years, especial in developed country. Smoking, diet and other factors. UC is more common in nonsmokers, but smoking increases the risk for CD. 2. Genetic factors There is an increased familial incidence of IBD. The onset of disease in patients from affected families occurs at a lower age than in those without family histories. Have a gene changed in IBD familial. HLA-DR2：患者频率＞普通人 3. Infective factors Antibiotics is useful for some IBD patient. IBD is characterized by an inflammatary reaction in the bowel resembling that caused by known microbiologic pathogens However, no specific infective organism has been consistently isolated. 4. Disturbance of immunity Usually concomitant presence of extraintestinal conditions, such as Erythema, Nodes, Arthritis, and Vasculitis. Anticolon antibodies has been discribed in UC. Antilymphocyte antibodies have been found in 40% of UC. Treated with adrenl cortical hormone can remit symptoms of IBD. 环境因素 遗传易感者 微生物 肠道免疫系统 免疫反应和炎症 （UC、CD） Ulcerative Colitis Definition 是一种病因不明的慢性非特异性溃疡性 直肠和结肠炎 好发部位：大肠，直、乙状结肠 病理改变：以溃疡形成为特征 临床表现：腹泻、粘液脓血便、腹痛 Epidemiology ⒈发病率 incidence 地区差异：欧美多见，亚非少见 我国 发病率低且轻 ⒉发病年龄age：20～40岁（65%） ⒊发病性别sex：男女几乎相等 pathology ⒈好发部位 location 大肠， 直肠、乙状结肠 ⒉病变分布 distribution 连续性分布 粘膜及粘膜下层 ⒊病变特点 早期： 弥漫充血、水肿、灶状出血 粘膜细颗粒状、质脆、易出血 广泛浅小溃疡 后期：炎性息肉 po