7．感染性腸炎の治療，予後，合併症

Treatment, Prognosis and Complications in Infectious Enteritis and Colitis

要旨　感染性腸炎は下痢，腹痛，発熱を主徴とする．コレラの下痢がenterotoxinによるcyclic AMP依存性分泌性下痢であることがわかり，その後様々な感染性腸炎の病態が細菌が産生する毒素によって起こることがわかった．治療には，下痢による脱水状態の改善，病原体に対する抗菌薬や抗生物質の投与，整腸薬による腸内細菌叢の是正，およびワクチンによる予防がある．合併症は脱水による循環不全およびこれによる腎障害，志賀毒素による溶血性尿毒症症候群，血栓性血小板減少性紫斑病，および脳症，腸炎ビブリオの溶血毒による心筋障害，アメーバ赤痢の肝膿瘍などが代表的である．予後はこれらの合併症を来さなければ良好である．

　The main manifestations of infectious enterocolitis are diarrhea, abdominal pain and fever. Since the diarrhea of cholera has been found to occur due to cyclic AMP-dependent secretory secretion by enterotoxin, the pathophysiology of various infectious enterocolitis has been proven to be induced by toxins produced by enterobacteria. Treatments for infectious enterocolitis are improvement of dehydration, administration of bactericidal drugs and antibiotics, normalization of enterobacterial flora with indigestion medicine, and prevention by vaccine. Representative complications are circulatory collapse due to dehydration and related renal disturbance, hemolytic uremic syndrome, thrombotic thrombocytopenic purpura and encephalopathy due to Shigatoxin, cardiac arrest caused by haemolysin of Vibrio parahaemolyticus, liver abscess of amoebic dysentery, and so on. Prognosis would be rather good without such complications as have been mentioned above.