{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,2,15]],"date-time":"2024-02-15T05:40:03Z","timestamp":1707975603263},"reference-count":50,"publisher":"Akademiai Kiado Zrt.","issue":"25","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2007,6,1]]},"abstract":"<jats:p>A colitis ulcerosa kezel\u00e9s\u00e9ben kevesebb a v\u00e1ltoz\u00e1s, mint a Crohn-betegs\u00e9gben. A betegek nagy t\u00f6bbs\u00e9ge ma is a hagyom\u00e1nyos gy\u00f3gyszereket kapja. A kezel\u00e9st meghat\u00e1roz\u00f3 legfontosabb t\u00e9nyez\u0151k a betegs\u00e9g kiterjed\u00e9se \u00e9s s\u00falyoss\u00e1ga. Az enyhe \u00e9s k\u00f6z\u00e9ps\u00falyos colitis ulcerosa kezel\u00e9s\u00e9nek a legfontosabb szerei az aminoszalicil\u00e1tok. Az \u00faj 5-aminoszalicil\u00e1tok ter\u00e1pi\u00e1s hat\u00e9konys\u00e1ga nem jobb, mint a sulfasalazin\u00e9, de kevesebb mell\u00e9khat\u00e1suk miatt el\u0151t\u00e9rbe ker\u00fclt az alkalmaz\u00e1suk. Proctitisben \u00e9s distalis colitisben a helyileg alkalmazott k\u00e9sz\u00edtm\u00e9nyek hat\u00e1sosabbak, mint az or\u00e1lis szerek, de a kiterjedt colitis gy\u00f3gyul\u00e1s\u00e1t is jav\u00edtja a kombin\u00e1lt lok\u00e1lis \u00e9s or\u00e1lis kezel\u00e9s. A s\u00falyos, akut colitis ulcerosa kezel\u00e9s\u00e9ben tov\u00e1bbra is meghat\u00e1roz\u00f3ak a kortikoszteroidok, a nem reag\u00e1l\u00f3 esetekben a cyclosporin vagy az infliximab lehet a colectomia alternat\u00edv\u00e1ja. Colitis ulceros\u00e1ban csaknem minden esetben indokolt a fenntart\u00f3 kezel\u00e9s. Valamennyi aminoszalicil\u00e1t alkalmas a remisszi\u00f3 fenntart\u00e1s\u00e1ra. Tov\u00e1bbra sem tiszt\u00e1zott az optim\u00e1lis aminoszalicil\u00e1t-d\u00f3zis k\u00e9rd\u00e9se. A distalis colitis remisszi\u00f3ban tart\u00e1s\u00e1ban leghat\u00e9konyabbak a lok\u00e1lis szerek, amennyiben a beteg ezt a kezel\u00e9st elfogadja. Kr\u00f3nikusan akt\u00edv, szteroidra rezisztens vagy szteroidf\u00fcgg\u0151 betegs\u00e9gben immunszuppressz\u00edv szerekt\u0151l, els\u0151sorban azathioprint\u00f3l v\u00e1rhatunk eredm\u00e9nyt. Az ut\u00f3bbi \u00e9vek felm\u00e9r\u00e9sei szerint colitis ulceros\u00e1ban az azathioprin legal\u00e1bb olyan hat\u00e9kony, mint Crohn-betegs\u00e9gben. A fenntart\u00f3 kezel\u00e9sben fontos szempont a kemoprevenci\u00f3. Mind t\u00f6bb adat bizony\u00edtja, hogy az aminoszalicil\u00e1tok cs\u00f6kkentik a colitis ulceros\u00e1ban fokozott colorectalis r\u00e1k kialakul\u00e1s\u00e1nak kock\u00e1zat\u00e1t. A legfontosabb v\u00e1ltoz\u00e1sok a colitis ulcerosa kezel\u00e9s\u00e9ben az ut\u00f3bbi \u00e9vekben a lok\u00e1lis aminoszalicil\u00e1tok \u00e9s az azathioprin el\u0151t\u00e9rbe ker\u00fcl\u00e9se, az infliximab alkalmaz\u00e1sa s\u00falyos colitisben, valamint a karcin\u00f3ma-kemoprevenci\u00f3 \u00e1ltal\u00e1noss\u00e1 v\u00e1l\u00e1sa. Nagyobb figyelmet kell ford\u00edtani a beteg egy\u00fcttm\u0171k\u00f6d\u00e9s\u00e9nek a megnyer\u00e9s\u00e9re, az el\u0151\u00edr\u00e1sok betart\u00e1s\u00e1ra.<\/jats:p>","DOI":"10.1556\/oh.2007.28063","type":"journal-article","created":{"date-parts":[[2007,6,19]],"date-time":"2007-06-19T21:38:19Z","timestamp":1182289099000},"page":"1163-1170","source":"Crossref","is-referenced-by-count":3,"title":["Medical therapy of inflammatory bowel diseases: Ulcerative colitis"],"prefix":"10.1556","volume":"148","author":[{"given":"L\u00e1szl\u00f3","family":"Lakatos","sequence":"first","affiliation":[{"name":"1 Csolnoky Ferenc Megyei K\u00f3rh\u00e1z I. Belgy\u00f3gy\u00e1szati Oszt\u00e1ly Veszpr\u00e9m K\u00f3rh\u00e1z u. 1. 8200"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P\u00e9ter L\u00e1szl\u00f3","family":"Lakatos","sequence":"additional","affiliation":[{"name":"2 Semmelweis Egyetem, \u00c1ltal\u00e1nos Orvostudom\u00e1nyi Kar I. 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