诊断学理论与实践2025，Vol.24Issue(4)：373-382,10.DOI:10.16150/j.1671-2870.2025.04.003
全球炎症性肠病的流行趋势分析及诊治现状
Analysis of global trends and current status of diagnosis and treatment of inflammatory bowel diseas
摘要
Abstract
Inflammatory bowel disease(IBD)is a group of chronic,recurrent,nonspecific inflammatory intestinal disorders of unknown etiology,primarily comprising ulcerative colitis(UC)and Crohn's disease(CD).Over the past 30 years,IBD has transitioned from a traditional"Western disease"to a truly global disease.The prevalence of IBD in North America and Europe has stabilized at 0.5%-1.0%,while newly industrialized countries in Asia,Latin America,and Africa are experiencing a 5 to 10-fold surge in IBD incidence.It is projected that the total number of IBD patients in Asia will exceed 4 million by 2035.From 1990 to 2019,the number of IBD patients in China increased from 133 000 to 484 000 in males and from 107 000 to 427 000 in females.The age-standardized incidence of IBD in Chinese males and females increased from 1.72/100 000 and 1.20/100 000 to 3.35/100 000 and 2.65/100 000,respectively.By 2030,the number of IBD patients in China is projected to exceed 1 million.In terms of diagnosis,magnetic resonance enterography(MRE),com-puted tomography enterography(CTE),and video capsule endoscopy(VCE)have significantly improved the visualization of small bowel lesions.Fecal calprotectin(FC)(optimal threshold of 152 μg/g)can predict relapse,with a sensitivity of 72%and a specificity of 74%.Anti-neutrophil cytoplasmic antibody(ANCA)and anti-saccharomyces cerevisiae antibody(ASCA)can also provide a non-invasive basis for differentiating UC and CD.The multidisciplinary team(MDT)model has improved the diagnosis rate of difficult cases by 20%.In the field of treatment,conventional therapies including 5-amino-salicylic acid,corticosteroids,and immunomodulators remain the foundation.However,biologics and small molecule tar-geted drugs such as anti-tumor necrosis factor-α agents,anti-interleukin(IL)-12/23 agents,and Janus kinase inhibitors have become the core treatments for patients with moderate to severe IBD,achieving induction remission rates of 50%-70%.Endoscopic dilation,endoscopic mucosal resection,endoscopic submucosal dissection,or laparoscopic surgery combined with enhanced recovery after surgery can significantly reduce trauma.Exclusive enteral nutrition and probiotic interven-tions can achieve a remission rate of 60%-70%in pediatric CD patients.However,the accessibility of biologics in primary hospitals in China is less than 30%,and the implementation rate of enhanced recovery after surgery is below 40%,indica-ting a significant gap compared with Europe and America.In the future,a national IBD registry system should be estab-lished,and research on early diagnostic models based on artificial intelligence(AI)and pharmacoeconomics should be con-ducted to achieve precise prevention and treatment of IBD and alleviate the societal burden of the disease.关键词
炎症性肠病/流行趋势/诊治现状/溃疡性结肠炎/克罗恩病Key words
Inflammatory bowel disease/Epidemiological trends/Current status of diagnosis and treatment/Ulce-rative colitis/Crohn's disease分类
医药卫生引用本文复制引用
杨翠萍,陈平..全球炎症性肠病的流行趋势分析及诊治现状[J].诊断学理论与实践,2025,24(4):373-382,10.基金项目
上海交通大学医学院附属瑞金医院广慈金光计划(GCQH02024-17) （GCQH02024-17）
上海交通大学医工交叉项目(YG2024LC01) （YG2024LC01）
