炎症性肠病（inflammatory bowel disease，IBD）是一组病因尚未完全明确的慢性、复发性、非特异性肠道炎性疾病，主要包括溃疡性结肠炎（ulcerative colitis，UC）和克罗恩病（Crohn's disease，CD）。近30年来，IBD已由传统的“西方疾病”转变为真正的全球性疾病，北美、欧洲的IBD患病率稳定在0.5%~1.0%，而亚洲、拉丁美洲及非洲的新兴工业化国家正经历IBD发病率5~10倍的跃升，预计到2035年亚洲IBD总患病人数将突破400万。从1990年到2019年，中国男性IBD患病人数从13.3万例增加到48.4万例，女性从10.7万例增加到42.7万例，中国男性和女性的IBD年龄标准化发病率分别从1.72/10万和1.20/10万增加到3.35/10万和2.65/10万。预计2030年我国IBD患者数量将突破百万。诊断方面，磁共振小肠造影（magnetic resonance enterography，MRE）、CT小肠造影（computed tomography enterography，CTE）及胶囊内镜（video capsule endoscopy，VCE）显著提高了小肠病变的可视化水平；粪便钙卫蛋白（fecal calprotectin，FC）（最佳临界值为152 μg/g）可预测复发，灵敏度为72%，特异度为74%；抗中性粒细胞胞浆抗体（anti-neutrophil cytoplasmic antibody，ANCA）和抗酿酒酵母抗体（anti-saccharomyces cerevisiae antibody，ASCA）也可为UC与CD鉴别提供无创依据；多学科协作（multidisciplinary team，MDT）模式使疑难病例确诊率提升20%。治疗领域，传统的5-氨基水杨酸、糖皮质激素、免疫抑制剂治疗仍是基础，但抗肿瘤坏死因子α、抗白细胞介素（interleukin，IL）-12/23（抗IL-12/23）、Janus激酶抑制剂等生物制剂和小分子靶向药物已成为中重度IBD患者的核心治疗手段，诱导缓解率达50%~70%；内镜下扩张、内镜下黏膜切除术、内镜黏膜下剥离术或腹腔镜手术＋加速术后康复可显著减少创伤；全肠内营养及益生菌干预对CD儿童患者的缓解率可达60%~70%。然而，国内基层医院生物制剂可及率不足30%，加速术后康复实施率<40%，与欧美仍有显著差距。未来应建立全国IBD登记系统，开展基于人工智能（artificial intelligence，AI）的早期诊断模型和药物经济学研究，以实现IBD精准防治，并减轻社会疾病负担。

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), computed 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-aminosalicylic acid, corticosteroids, and immunomodulators remain the foundation. However, biologics and small molecule targeted 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 interventions 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 established, and research on early diagnostic models based on artificial intelligence (AI) and pharmacoeconomics should be conducted to achieve precise prevention and treatment of IBD and alleviate the societal burden of the disease.