非感染性葡萄膜炎的免疫抑制治疗

Immunosuppressive therapy for noninfectious uveitis

葡萄膜炎是一种难治性的致盲眼病。其中,非感染性葡萄膜炎是一种自身免疫介导的炎症反应性疾病,目前的治疗手段主要是免疫抑制治疗。现有的免疫抑制剂主要包括激素和激素替代制剂。常用的激素替代制剂包括:抗代谢药、磷酸酶抑制剂、烷化剂、生物制剂、中药制剂及一些正在研制的新药。当需要长期使用大剂量激素或者应用激素出现严重副作用时应该考虑应用激素替代制剂。每种免疫抑制剂都有各自的适用范围和不良反应,所以根据不同患者的具体情况选择合适的联合治疗方案是十分必要的。在达到提高治疗葡萄膜炎治疗效果的同时最大可能减轻副作用控制并发症,提高葡萄膜炎患者的生存质量。

Uveitis is a kind of refractory disease which can lead to permanent vision loss. Noninfectious uveitis is an important part of uveitis, which is thought to be autoimmune mediated inflammation. The current treatment is immunosuppressive therapy, consisting of corticosteroids and steroid sparing agents including antimetabolites, T-ceU inhibitors, alkylating agents, biologic agents, traditional Chinese preparation and emerging drugs being developed. Corticosteroid sparing agents are indicated when patients require long-term high-dose steroids to control ocular inflammation or can＇ t tolerate side effects of corticosteroids. Different therapeutic options have their own indication and side effects, so it is very necessary to select the proper option for a particular case. As our understanding of autoimmune diseases expands, more new drugs with higher efficiency and less side effects should be developed.