药源性显微镜下结肠炎与药物性结肠炎的诊治进展  

Progress in the diagnosis and treatment of drug-induced microscopic colitis and medicine related colitis

作　　者：邱竹箐 李琴 陈东风 魏艳玲 QIU Zhuqing;LI Qin;CHEN Dongfeng;WEI Yanling(Department of Gastroenterology,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学附属第三医院消化内科,重庆400042

出　　处：《胃肠病学和肝病学杂志》2022年第6期696-700,共5页Chinese Journal of Gastroenterology and Hepatology

摘　　要：药源性显微镜下结肠炎(drug-induced microscopic colitis,DIMC)和药物性结肠炎均为药物相关性结肠炎。两者皆为药物所导致的结肠炎,临床症状有所重叠,治疗方案不尽相同,治疗结局也较为相似,但却为两种不同性质的疾病。其在致病药物、结肠镜下表现及病理组织学特征上均有不同。目前全球尚无统一的DIMC及药物性结肠炎诊治共识,国内临床医师对两种疾病的认识不足、结肠镜下黏膜活检率低导致临床极高的误诊、漏诊率。本文从药源性显微镜下结肠炎和药物性结肠炎的流行病学、致病药物、发病机制及危险因素、临床症状、结肠镜表现及病理组织学、诊断标准、治疗的研究进展进行总结,为这两种疾病的临床诊治提供参考。Drug-induced microscopic colitis and medicine related colitis are all belong to drug-related colitis.Both of the two kinds of colitis are caused by drugs.Their clinical symptoms,treatment options and clinical outcomes are relatively similar,but the 2 diseases are different nature.There are differences in pathogenic drugs,colonscopy and histopathological features.At present,there is no unified consensus on the diagnosis and treatment of DIMC and medicine related colitis in the world,the insufficient understanding of the 2 diseases by clinicians in China and low rate of mucosal biopsy under colonscopy cause the high misdiagnosis and missd diagnosis.In this paper,the epidemiology,pathogenic drugs of pathogenesis and risk factors,clinical symptoms,colonscopy manifestations,histopathology,diagnosis criteria and treatment were summarized to provide references for the diagnosis and treatment of the 2 diseases.

关 键 词：药源性显微镜下结肠炎 药物性结肠炎 非出血性腹泻 

分 类 号：R574[医药卫生—消化系统]