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特集 10年前の常識は非常識!?—イマドキ消化器診療にアップデート
疾患
文献概要
潰瘍性大腸炎，Crohn病を主とする炎症性腸疾患（inflammatory bowel disease：IBD）は原因不明の難治性疾患であり，その患者数は近年増加の一途を辿る．かつてのIBDの治療は食事・栄養療法が主体であったが，その後サラゾスルファピリジン（salazosulfapyridine：SASP），5-アミノサリチル酸（5-aminosalicylic acid：5-ASA）製剤，副腎皮質ステロイド薬（ステロイド）を主体とする薬物療法，そして現在はさまざまな分子標的薬へと移行した．新たな治療薬によりIBDの治療目標は症状の緩和から内視鏡的粘膜治癒1,2），そして組織学的治癒へとハードルが上がったといえる．診断機器はX線造影検査から内視鏡，カプセル内視鏡3〜5），バルーン内視鏡6〜8），そしてCT enterograph，MR enterography（MRE）へ，バイオマーカーとして赤血球沈降速度（赤沈），C反応性蛋白（C reactive protein：CRP）に加えて便カルプロテクチン，ロイシンリッチα2グリコプロテイン（Leucine-rich alpha 2 glycoprotein：LRG）など，新規の検査法や新薬の開発によりIBDの診断・治療はこの10年で大きな変遷を遂げた．
参考文献
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