溃疡性结肠炎病情评估2013.pptVIP

Evaluation and assessment Before starting treatment, patients need to be re-evaluated for correct diagnosis, and to ensure that other colitis and colonic lesions have been excluded. The anatomical location and extent of inflammation, severity and disease activity, presence of extraintestinal manifestations and complications etc. should be scrutinized to decide the best form of treatment. It is essential to remember that a correct diagnosis is based on the combination of clinical, endoscopic, radiological and histological data. 2nd European evidence-based consensus on the diagnosis/management of ulcerative colitis 2012 Clinical Subtype Truelove and Witts Severity Index Montreal classification According to Disease Extent Montreal classification According to Disease Severity Sutherland Index （DAI） Mayo Score Sutherland Index (also called Mayo scores) Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis, a randomized study. N Engl J Med 1987;317:1625–9. Sutherland LR, Martin F, Greer S, et al. 5-Aminosalicylic acid enema in the treatment of distal ulcerative colitis, proctosigmoiditis, and proctitis. Gastroenterology 1987;92:1894–8. Endoscopic scores Baron endoscopic scores Endoscopic scores (UCEIS ) Histologic findings Truelove SC, Richards WC. Biopsy results in ulcerative colitis. Br Med J. 1956;1:1315–1318. Riley SA, Mani V, Goodman MJ, et al. Microscopic activity in ulcerative colitis: what does it mean? Gut. 1991;32:174–178. Geboes K, Riddell R, Ost A, et al. A reproducible grading scale for histological assessment of inflammation in UC. Gut. 2000;47: 404–409. Bitton A, Peppercorn MA, Antonioli DA, et al. Clinical, biological, and histologic parameters as predictors of relapse in ulcerative colitis. Gastroenterology. 2001;120:13–20. Thia KT, Loftus EVj, Pardi DS, et al. Measurement of disease activity in ulcerative colitis: Interobserver agreement and predictors of severity. Inflam