臨牀消化器内科 Vol.16 No.10(1)


特集名 重症潰瘍性大腸炎に対する最新の戦略
題名 潰瘍性大腸炎重症化の誘因と機序
発刊年月 2001年 09月
著者 朝倉 均 新潟大学大学院医歯学総合研究科消化器内科学分野(第三内科)
【 要旨 】 潰瘍性大腸炎の重症度はTrueloveらの重症度分類を参考にして,排便回数,顕血便,頻脈,赤沈,発熱,貧血の6項目で規定されている.本症の重症化に関与する因子を,全大腸炎型などの罹患範囲,粘膜内好中球浸潤,慢性化とmemory Tリンパ球,腸内細菌のLPS,ANCAなどの自己抗体と粘膜基底部の形質細胞浸潤,催炎症性サイトカイン・バランス,HLAなどの疾患感受性遺伝子,中毒性巨大結腸症や静脈血栓形成などの腸管内外の合併症などの面から考察した.
Theme The Newest Strategies for Severe Ulcerative Colitis
Title Factors and Mechanisms Involved in Ulcerative Colitis Severity
Author Hitoshi Asakura Department of Gastroenterology and Hepatology, Niigata University School of Medicine
[ Summary ] The degree of severity of ulcerative colitis is defined by Truelove's criteria, composed of 6 criterias: frequency of bowel movements, bloody stools, tachycardia, red blood cell sedimentation rate, fever, and anemia. Factors involved in severity of ulcerative colitis were discussed from the viewpoint of the extent of diseased segments, such as the entire colitis, mucosal infiltration of neutrophils, memory T lymphocytes, disease chronicity, LPS produced by enteric germs, autoantibodies such as ANCA, basal infiltration of plasma cells, proinflammatory cytokines and their balance, disease susceptibility genes, such as HLA, and intestinal or extraintestinal complications, such as toxic megacolon and venous thrombosis.
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