炎症性肠病患者应用抗TNF-α单抗发生结核风险的研究进展

Research progress on the risk of tuberculosis in patients with inflammatory bowel disease treated with anti-TNF-αmonoclonal antibody

炎症性肠病(IBD)是一种胃肠道慢性非特异性复发性炎症性疾病。抗肿瘤坏死因子-α(TNF-α)单抗的出现极大地改善了IBD患者的预后,但同时也增加了患者发生活动性结核的风险。中国是结核高负担国家,临床医生应高度重视抗TNF-α单抗导致结核的风险。该文回顾了潜伏性结核感染及再激活的机制、抗TNF-α单抗导致结核的风险,以及国内外指南的诊疗推荐,期望能为合并潜伏性结核感染的IBD患者在应用抗TNF-α单抗时提供一些参考依据。

Inflammatory bowel disease(IBD)is a chronic non-specific recurrent inflammatory disease of the gastrointestinal tract.The emergence of anti-tumor necrosis factor-α(TNF-α)monoclonal antibody has greatly improved the prognosis of IBD patients,but also increased the risk of active tuberculosis.China is a country with high burden of tuberculosis and clinicians should attach great importance to the risk of tuberculosis caused by anti-TNF-αmonoclonal antibody.This paper reviews the mechanism of latent tuberculosis infection and reactivation,the risk of tuberculosis caused by anti-TNF-αmonoclonal antibody,and the diagnosis and treatment recommendations of domestic and foreign guidelines.It is expected to provide some references for IBD patients with latent tuberculosis infection when using anti-TNF-αmonoclonal antibody.