硫唑嘌呤治疗炎症性肠病诱发淋巴瘤

Risk of lymphoma after treatment of infiammatory bowel disease with azathioprine

炎症性肠病(inflammatory bowel disease,IBD)是一类肠道免疫系统过度激活引起的慢性非特异性炎症性疾病,包括溃疡性结肠炎(ulcerative colitis,UC)与克罗恩病(Crohn's disease,CD).免疫抑制剂在IBD患者中广泛应用,且对于IBD治疗有效,但是这些药物诱发淋巴瘤的发生报道越来越多,尤其以硫唑嘌呤(azathioprine,AZA)为甚.AZA治疗IBD是否使淋巴瘤风险增加引起越来越多的关注.本文主要对于AZA在IBD临床应用、诱发淋巴瘤发生的可能机制、风险评估等进行讲述.

Infiammatory bowel disease（IBD） is a chronic,non-specific inflammatory disease of the intestine,characterized by excessive activation of the immune system.Immunosuppressive therapy has been widely and effectively used in IBD patients.However,the occurrence of lymphoma after immunosuppressive therapy for IBD,especially azathioprine,has been recently reported.This article reviews the clinical application of azathioprine in IBD,the possible mechanisms responsible for lymphoma induction by azathioprine,and the assessment of benefit and risk of immunosuppressive therapy for IBD.