Chowdhury Reezwana博士:缓解。我认为我们使用各种因素。一,显然是临床症状和临床疾病活动指数,我们通常喜欢观察每个访问。所以在诊所访问,我们会问这类问题的目标参数,观察别人的炎症标记物,如c反应蛋白,ESR或calprotectin大便。显然,乌维会做结肠镜检查和活检。使用内窥镜,看看他们以前有溃疡或严重的炎症。他们的结肠看起来改进之前的没有更多的溃疡,没有re-adhesion吗?它看起来像的人从来没有疾病。可以,可以实现。当我们考虑到内窥镜缓解。 And then if someone’s had small bowel disease and MRI, if that’s how their inflammation was sought, we would repeat an MRI to see if there’s still inflammation in that area. So all of those together to me would be basically endoscopic slash clinical remission. Now, when we do these, molonoscopies, endoscopies, we do take biopsies. So then that the next question is the biopsies; do those show active inflammation? Or quiescent inflammation? So then that’s a whole other kind of conversation that’s happening in the IBD world. Do we treat to target that the biopsies being essentially normal or showing quiescent or inactive disease? For me, if a patient’s endoscopic evaluation looks good, as well as their clinical symptoms, I would consider them to be in remission.
博沈博士:是的。我同意Chowdhury博士。就像他们,你找到缓解,它应该是一个综合评估。我想说至少两套标记,症状,除了内窥镜检查,也许有点实验室。这是我做的一件事是关于症状,对吧?症状,问题是他们不可靠。第一是客观的发现。例如,目标在内镜炎症,然后患者主观症状几乎是不相关的。的另一件事情你做的是有条件经常使用称为退化。人病了很久然后习惯,疾病。 They may feel like this is the normal. So I’ll give you example. There’s a patient I saw and I say, David, how are you? How are you doing? I’m doing great. Okay. Let’s do colonoscopy. No symptoms. Then, when I took the colonoscopy, I found, you know what? T issue paper in between the buttock cheeks. I said, you said you don’t have symptoms. Yes. I don’t have symptoms. I said, how many people, like healthy people, put their tissue paper in between the buttock cheeks. I said, yeah, when you asked it because I leak all the time. Either leak since either diagnosed 10 years ago. Right? So you consider it as normal. As a matter of fact, it’s not normal. So that’s why the symptoms not totally accurate. And then of course if you use the endoscopy, it would be the cost, right? So that’s why you, the endoscopy we consider, if you measure remission by the expensive tool. Now, if the cheaper tool the people use the labs, right. Lab in general, labs include anemia, nutrition, like albumin, and then other inflammatory marker, like the CRP, sedimentation rate. So it’s a combination. Just the bottom line is that the symptoms alone is not enough.
