胃と腸59巻10号

2024年10月発行

増大号 炎症性腸疾患2024

主題 炎症性腸疾患の長期経過

Crohn病の長期予後

著者： 今給黎宗¹ 芦塚伸也¹ 犬尾和子¹ 柯懿玲¹ 木村俊大¹ 黒木大世¹ 能丸遼平¹ 松岡弘樹¹ 久能宣昭¹ 船越禎広¹ 塩川桂一² 長谷川傑² 平井郁仁¹

所属機関： ¹福岡大学医学部消化器内科学講座 ²福岡大学病院消化器外科

ページ範囲：P.1531 - P.1542

文献概要

要旨●Crohn病は再燃・寛解を繰り返す慢性の炎症性腸疾患である．初期には炎症型が多いが，経時的に狭窄型・穿通型に進展し，手術に至ることも少なくない．しかし抗TNFα抗体製剤が登場したことで治療成績は大きく飛躍し，症状のみならず粘膜治癒を目指せるようになった．現在ではtreat to targetの概念に基づいた治療戦略が提唱されている．近年では作用機序の異なる生物学的製剤が複数開発され，内科治療は年々進化を遂げている．このような治療の進歩により入院，手術，腸管合併症などの長期予後は徐々に改善していると言えよう．一方で効果減弱や薬剤選択といった新たな問題を生み出している．術後再発率も依然として高い．真の長期予後の評価には，今後もさらなる疫学調査が必要である．

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