抗肿瘤坏死因子抗体在炎症性肠病中的应用策略

Application Strategy of Anti-TNFα Monocolonal Antibodies in Treating Inflammatory Bowel Diseases

抗肿瘤坏死因子α单克隆抗体(ATMA)已成为治疗激素无效和(或)依赖的炎症性肠病的主要药物。它可以促进黏膜愈合、瘘管闭合,减少手术率,改善患者生活质量。其不良反应包括输液反应、变态反应、严重感染(如结核)、淋巴瘤等,影响继续使用ATMA进行治疗。合理的ATMA使用时机、治疗方案使患者在治疗中受益,增加成本-效益。该文综述ATMA在炎症性肠病患者中的使用方法及不良反应,特别是儿童、孕妇、老年等特殊患者中的使用情况,以期为ATMA在临床上的合理使用提供依据。

Anti-TNF-α monocolonal antibodies （ATMA） are major medication for patients with corticoste- roid-refractory and/or corticosteroid-dependent inflammatory bowel disease（IBD） at present. They are effective for the healing of the mucosa,fistula closure,and reducing the need of surgery,and finally improving quality of life. The side effects include infusion reaction, allergic reaction, severe infection （ such as tuberculosis ） and lymphoma, which affect the further using of ATMA. IBD patients could benefit with increased benefitcost from the ATMA when they are treated with ATMA in proper time with proper regime. Here is to make a review of the optimal use and adverse effect of ATMA in patients with IBD,especially in children,pregnant women and the elder,with the hope to provide some references for the rational use of ATMA in clinical practice.