炎症性肠病患者接受生物治疗前潜伏结核感染筛查方法：PPD 还是 IGRA？

Approach to Latent Tuberculosis Infection Screening Before Biologic Therapy in IBD Patients: PPD or IGRA?

机构信息

Division of Gastroenterology, American University of Beirut, Beirut, Lebanon.

Bellevue Medical Center, Beirut, Lebanon.

出版信息

Inflamm Bowel Dis. 2020 Aug 20;26(9):1315-1318. doi: 10.1093/ibd/izaa139.

DOI:10.1093/ibd/izaa139

PMID:32483628

Abstract

The use of biological agents for the treatment of chronic inflammatory conditions such as inflammatory bowel diseases (IBD) has been on the rise.1,2 Current biological therapies include antitumor necrosis factor-α (anti-TNF-α), anti-interleukin-12/23, and anti-integrin agents. Before initiation of biological drugs, screening for Mycobacterium tuberculosis infection is required to avoid reactivation or worsening of disease after immunosuppression. It has been shown that anti-TNF-α treated patients have a 14-fold increased risk of tuberculosis (TB) infection/reactivation compared with healthy controls.3 The methods for screening for TB have evolved over time and vary from region to region.

摘要

生物制剂在治疗炎症性肠病（IBD）等慢性炎症性疾病方面的应用呈上升趋势。1,2 目前的生物治疗包括抗肿瘤坏死因子-α（anti-TNF-α）、抗白细胞介素-12/23 和抗整合素药物。在开始使用生物药物之前，需要筛查结核分枝杆菌感染，以避免免疫抑制后疾病的复发或恶化。已经表明，与健康对照相比，接受抗 TNF-α 治疗的患者患结核病（TB）感染/复发的风险增加了 14 倍。3 筛查 TB 的方法随着时间的推移而不断发展，且在不同地区有所差异。