抗TNF-α药物治疗炎症性肠病后诱发银屑病的研究进展  

Research progress on the treatment of psoriasis induced by anti-TNF-αdrugs in the treatment of inflammatory bowel disease

作　　者：袁琳琳 张慧玲[1] 李冬 海双双 彭娜 刘维新[1] Yuan Linlin;Zhang Huiling;Li Dong;Hai Shuangshuang;Peng Na;Liu Weixin(The First Affiliated Hospital of China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《实用药物与临床》2023年第7期658-663,共6页Practical Pharmacy and Clinical Remedies

摘　　要：抗肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)类药物作为一种生物制剂,在炎症性肠病(Inflammatory bowel disease,IBD)中的应用日益广泛,然而近几年关于其治疗IBD时发生皮肤不良反应的报道也越来越多,银屑病是其中较为常见的一种。关于抗TNF-α药物诱导银屑病的发病机制尚不明确,可能涉及免疫因素、遗传易感性、肠道微生物等多方面。目前,临床上还没有明确的针对抗TNF-α药物治疗IBD过程中诱发银屑病的治疗指南,其治疗策略可能需根据患者的皮损程度和IBD的严重程度来综合考虑,对于停用抗TNF-α药物后皮损未缓解或IBD肠道表现控制不佳的患者,乌司奴单抗可作为替换的生物制剂继续治疗。然而对于这种疾病的处理仍然是临床医生面临的问题,需要更多的基础及临床研究提供新的指导意见。本文旨在对于抗TNF-α药物应用于IBD后诱发银屑病的发病风险、发病特点、发病机制及处理措施等相关研究结果进行综述。Anti-tumor necrosis factor-α(TNF-α)drug,as a biologic agent,is increasingly widely used in inflammatory bowel disease(IBD).However,in recent years,more and more adverse skin reactions have been reported during the treatment.Psoriasis is one of the common ones.The pathogenesis of psoriasis induced by anti-TNF-αdrugs is still unclear,which may involve immune factors,genetic susceptibility,intestinal microorganisms,etc.At present,there is no clear clinical guidelines for treating psoriasis in patients with IBD under treatment with anti-TNF-αagents,and the selection of treatment strategies may need to be considered comprehensively according to the degree of patients′skin lesions and the severity of IBD.For patients with no relief of skin lesions or poor control of intestinal manifestations of IBD after discontinuation of anti-TNF-αdrugs,ustekinumab can be used as a substitute biological agent to continue treatment.However,the management of this disease is still a problem for clinicians,which requires more clinical and basic research to provide new guidance.This paper aims to review the risks,characteristics,pathogenesis and treatment for psoriasis induced by anti-TNF-αdrugs used in IBD.

关 键 词：炎症性肠病 生物制剂 银屑病 

分 类 号：R758.63[医药卫生—皮肤病学与性病学] R574[医药卫生—临床医学]