Afif Waqqas, Loftus Edward V
Division of Gastroenterology and Hepatology, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Med Clin North Am. 2010 Jan;94(1):115-33. doi: 10.1016/j.mcna.2009.08.016.
Over the last decade, the medical treatment of inflammatory bowel disease (IBD) has been revolutionized, with increasing use of both immunomodulatory and biologic medications. Corticosteroids have increasingly been shown to increase the risk of serious and opportunistic infections, both independently and in combination with immunomodulator and biologic agents. There are limited data on the infectious risk of immunomodulators. It is unclear if anti-tumor necrosis factor-alpha agents increase overall infectious risk in patients with IBD, but the available literature has demonstrated an increased risk of opportunistic infections, particularly in terms of tuberculosis and histoplasmosis. Combination therapy likely increases the risk of opportunistic infections in patients with IBD but this has not yet been conclusively proved.
在过去十年中，炎症性肠病（IBD）的医学治疗发生了变革，免疫调节药物和生物药物的使用越来越多。越来越多的证据表明，皮质类固醇会独立或与免疫调节剂及生物制剂联合使用时增加严重感染和机会性感染的风险。关于免疫调节剂感染风险的数据有限。目前尚不清楚抗肿瘤坏死因子-α药物是否会增加IBD患者的总体感染风险，但现有文献表明机会性感染风险增加，尤其是在结核病和组织胞浆菌病方面。联合治疗可能会增加IBD患者机会性感染的风险，但这尚未得到确凿证实。
