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溃疡性结肠炎(UC)是一种慢性炎症性肠病(IBD)，其特征是仅限于直肠和结肠粘膜的肠道炎症。1在就诊时，约30%的患者仅有直肠炎症，称为溃疡性直肠炎(UP)。2 35年随访后，多达28%的患者可能发生近端结肠炎，49%的患者进展为广泛性结肠炎。4 - 8一项基于人群的儿科起病UC研究显示，25%的儿科UC患者在诊断时出现UP，其中49%的患者在最大随访期出现结肠延伸。9
UP的具体定义为病变不超过直肠(即炎症近端远端至直肠乙状结肠连接处)。10然而，UP并没有一个通用的定义标准。蒙特利尔分类将UC的分布只分为UP (E1:局限于直肠)、左侧结肠炎(E2:延伸至脾曲)和广泛性结肠炎(E3:超出脾曲)。11日12美国胃肠病学协会(AGA)指南将直肠炎定义为仅限于直肠或距离肛门15-20厘米以内的炎症。13
临床症状因疾病程度不同而不同。14UP可导致令人痛苦的症状，包括直肠出血增加、急症、大便渗漏、大便失禁和生活质量下降。4 - 6腹泻的存在是不同的，事实上多达20-30%的患者有运输延迟和便秘。14日15UC患者出现便秘与女性、活动性疾病和远端结肠受累有关。15在UP患者中缺乏这样的数据。这些患者的医疗管理可能具有挑战性，部分原因是关于UP治疗的数据有限。5日16UC和UP患者的治疗方法主要是…
脚注
贡献者LP-B构思了这项研究。BC写了文章，并创建了表格和图表。WJS、SS、RP、SD和LP-B对论文内容进行了严格的评审。手稿得到了所有作者的认可。
资金William Sandborn得到了niddk资助的圣地亚哥消化疾病研究中心(P30 DK120515)的部分支持。
相互竞争的利益WJS报告:研究资助来自Abbvie、Abivax、Arena Pharmaceuticals、Boehringer Ingelheim、Celgene、Genentech、Gilead Sciences、葛兰素史克、Janssen、礼来、辉瑞、Prometheus Biosciences、Seres Therapeutics、Shire、Takeda、Theravance Biopharma;Abbvie, Abivax, Admirx, Alfasigma, Alimentiv(以前的Robarts临床试验，由Alimentiv健康信托拥有)，Alivio Therapeutics, Allakos, Amgen, Applied Molecular Transport, Arena Pharmaceuticals, Bausch Health (Salix)， Beigene, Bellatrix Pharmaceuticals, Boehringer Ingelheim, Boston Pharmaceuticals, Bristol Meyers Squibb, Celgene, Celltrion, cell出品，Cosmo Pharmaceuticals, Escalier Biosciences, Equillium, Forbion, Genentech/Roche, Gilead Sciences，Glenmark Pharmaceuticals, Gossamer Bio, immune (Vital Therapies)， Index Pharmaceuticals，完整治疗，杨森，Kyverna治疗，兰多斯生物制药，礼来，Oppilan制药，大冢，Pandion治疗，辉瑞，Progenity, Prometheus生物科学，promoists生物科学，provtion生物，Reistone生物制药，Seres治疗，上海医药生物治疗，Shire, Shoreline Biosciences, Sublimity治疗，Surrozen, Takeda, Theravance生物制药，Thetis制药，Tillotts Pharma、UCB、Vendata Biosciences、Ventyx Biosciences、Vimalan Biosciences、Vivelix Pharmaceuticals、Vivreon Biosciences、Zealand Pharma;以及Allakos、BeiGene、Gossamer Bio、Oppilan Pharma、Prometheus Biosciences、Progenity、Shoreline Biosciences、Ventyx Biosciences、Vimalan Biosciences、Vivreon Biosciences的股票或股票期权。配偶:Iveric生物顾问，股票期权;Progenity-stock;Oppilan制药顾问，股票期权;Prometheus biosciences -员工，股票，股票期权;Ventyx biosciences -股票，股票期权; Vimalan Biosciences—stock, stock options. SS reports speaker, advisory and consulting roles for AbbVie, Amgen, Boehringer-Ingelheim, Bristol-Myers Squibb, Celgene, Eisai Medical Research, Eli Lilly, Ferring, Genentech, Gilead, Janssen, Merck, Pfizer, Shire Pharmaceuticals, Sandoz, Takeda, Tillotts, RP reports Consultant for: AbbVie, AGI Therapeutics, Alba Therapeutics, Amgen, Astellas, Athersys, Atlantic Healthcare, BioBalance, Boehringer-Ingelheim, Bristol-Myers Squibb, Celgene, CoMentis, Cosmo Technologies, Coronado Biosciences, Cytokine Pharmasciences, Eisai Medical Research, Elan, EnGene, Eli Lilly, Enteromedics, Ferring, Flexion Therapeutics, Genentech, Genzyme, Gilead, Given Imaging, GlaxoSmithKline, Human Genome Sciences, Ironwood, Janssen, Merck & Co., Merck Research Laboratories, MerckSerono, Nisshin Kyorin, Novo Nordisk, NPS Pharmaceuticals, Optimer, Orexigen, PDL Biopharma, Pfizer, Procter and Gamble, Santarus, Shire Pharmaceuticals, Sigmoid Pharma, Sirtris (a GSK company), Sandoz, S.L.A. Pharma (UK), Targacept, Teva, Therakos, Tillotts, TxCell SA, Speaker’s fees for Abbvie, Amgen, Celgene, Ferring, Janssen, Merck, Novartis, Pfizer, Prometheus, Sandoz, Shire, Takeda Advisory board attendance for Abbvie, Abbott, Allergan, Amgen,Biogen Idec, Eisai, Ferring, Genentech, Janssen, Merck, Shire, Elan, GlaxoSmithKline, Hospira, Pfizer, Bristol-Myers Squibb, Takeda, Cubist, Celgene, Salix, Roche. Research/educational support from Abbvie, Ferring, Janssen, Shire Takeda. SD has served as a speaker, consultant, and advisory board member for Schering-Plough, AbbVie, Actelion, Alphawasserman, AstraZeneca, Cellerix, Cosmo Pharmaceuticals, Ferring, Genentech, Grunenthal, Johnson and Johnson, Millenium Takeda, MSD, Nikkiso Europe GmbH, Novo Nordisk, Nycomed, Pfizer, Pharmacosmos, UCB Pharma and Vifor. LP-B has served as a speaker, consultant and advisory board member for Merck, Abbvie, Janssen, Genentech, Mitsubishi, Ferring, Norgine, Tillots, Vifor, Hospira/Pfizer, Celltrion, Takeda, Biogaran, Boerhinger-Ingelheim, Lilly, HAC Pharma, Index Pharmaceuticals, Amgen, Sandoz, Forward Pharma GmbH, Celgene, Biogen, Lycera, Samsung Bioepis, Theravance.
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