本文由小咖机器人翻译整理

期刊来源：Lancet

原文链接：https://doi.org/10.1016/S0140-6736(23)02586-2

摘要内容如下：

克罗恩病是一种胃肠道慢性炎症性疾病，可能导致进行性肠道损伤和残疾。克罗恩病的确切病因尚不清楚，但有证据表明，多因素事件会导致遗传易感人群的先天免疫系统失调。克罗恩病通常影响末端回肠和近端结肠，炎症通常是不连续的、斑片状、节段性和透壁性的。确定回肠结肠镜检查和组织学的特征性发现仍然是诊断的金标准，但完整的评估涉及实验室异常，包括微量营养素缺乏、横断面成像以确定透壁性疾病的范围、严重程度和并发症，以及心理社会评估。克罗恩病患者的治疗策略现在不仅仅是实现临床缓解，还包括更深层次的内镜愈合目标，并考虑辅助组织学和透壁目标，以进一步改变疾病进展。早期有效的先进疗法的使用和针对具有改进的安全性的替代新途径的疗法的开发，导致了克罗恩病治疗的新时代。未来，先进疗法与饮食或其他生物药物和小分子药物的结合，以及严格控制监测工具和预测生物标记物的改进，可能会继续改善克罗恩病患者的预后。

英文原文如下：

Abstracts

Crohn's disease is a chronic inflammatory disease of the gastrointestinal tract that might lead to progressive bowel damage and disability. The exact cause of Crohn's disease is unknown, but evidence points towards multifactorial events causing dysregulation of the innate immune system in genetically susceptible people. Commonly affecting the terminal ileum and proximal colon, Crohn's disease inflammation is often discontinuous and patchy, segmental, and transmural. Identification of characteristic findings on ileocolonoscopy and histology remains the diagnostic gold standard, but complete assessment involves laboratory abnormalities, including micronutrient deficiencies, cross-sectional imaging to identify transmural disease extent, severity and complications, and a psychosocial assessment. Treatment strategies for patients with Crohn's disease now go beyond achieving clinical remission to include deeper targets of endoscopic healing and consideration of adjunctive histological and transmural targets to alter disease progression potentially further. The use of early effective advanced therapies and development of therapies targeting alternative novel pathways with improved safety profiles have resulted in a new era of healing in Crohn's disease management. Future combination of advanced therapies with diet or other biological drugs and small molecules, together with improvements in tight control monitoring tools and predictive biomarkers might continue to improve outcomes for patients with Crohn's disease.

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