应用肿瘤坏死因子拮抗剂人群结核潜伏感染的检测及预防性治疗  

Testing and Prophylaxis of Latent Tuberculosis Infection in Patients Receiving Tumor Necrosis Factor-α Antagonists

作　　者：谭雨亭 侍效春[1] 刘晓清[1] TAN Yu-ting;SHI Xiao-chun;LIU Xiao-qing(Department of Infectious Diseases,Peking Union Medical College Hospital,Chinese Academy of Medical Sciences&Peking Union Medical College,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院北京协和医院感染内科,北京100730

出　　处：《协和医学杂志》2021年第1期86-91,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：艾滋病和病毒性肝炎等传染病科技重大专项(2017ZX100201302-003);中国医学科学院医学与健康科技创新工程(2016-I2M-1-013)。

摘　　要：肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)拮抗剂的使用是发生活动性结核的高危因素,尤其对于潜伏结核感染(latent tuberculosis infection,LTBI)患者,结核再活动的风险更高。2015年世界卫生组织发布的LTBI管理指南强烈推荐在应用TNF-α拮抗剂前应进行LTBI筛查,并推荐了5种治疗方案,然而,该指南中关于5种方案在此类人群中的有效性和安全性尚无数据。接受TNF-α拮抗剂治疗人群LTBI的筛查和治疗方案选择应受到重视。本文主要综述应用TNF-α拮抗剂LTBI的筛查和治疗,以期为该类人群LTBI的管理提供依据。Treatment with tumor necrosis factor-α(TNF-α)antagonists is a risk factor for active tuber-culosis.Especially for patients with latent tuberculosis infection(LTBI),the risk of tuberculosis reactivation is greater,which lays weight on the importance of the screening of LTBI and the choice of treatment regimens in this population.2015 World Health Organization(WHO)guidelines on the management of LTBI strongly rec-ommended that patients should receive LTBI screening before using TNF-αantagonists.Furthermore,there were five regimens recommended.However,no data are available on the efficacy and safety of the five regimens in this population in WHO guidelines.This review focuses on the screening and treatment of LTBI in patients re-ceiving TNF-αantagonists,in order to provide a basis for the management of LTBI in clinical practice.

关 键 词：肿瘤坏死因子-Α拮抗剂 潜伏结核感染 管理 

分 类 号：R593.2[医药卫生—内科学] R52[医药卫生—临床医学]