Gastroenterology:炎症性肠病免疫抑制治疗与机会性感染风险

2018-04-16 zhangfan MedSci原创

研究发现炎症性肠病患者不同免疫抑制方案治疗导致的严重和机会性感染风险存在较大差异,在临床实践过程中需仔细权衡不同治疗方案的治疗收益

炎症性肠病患者的治疗过程中,与TNF抑制剂和巯嘌呤类药物治疗相关的感染风险尚不清楚。近日研究人员在法国IBD患者中考察了巯嘌呤类单药、TNF单药或联合治疗导致的严重机会性感染发病率。

研究人员在全国范围内对成年IBD病人进行这项基于人口的研究,利用COX比例风险模型考察与IBD治疗相关的严重机会感染风险。

190694名患者参与研究,总计发生8561起严重感染以及674起机会感染。相比于抗TNF单药治疗,联合治疗导致严重(HR,1.23;95% CI,1.05-1.45)以及机会性感染(1.96;95% CI,1.32-2.91)风险增加。相比于巯嘌呤类单药治疗,抗TNF单药治疗导致患者严重感染(HR,1.71;95% CI,1.56-1.88)、结核菌感染(HR,1.98;95% CI,1.15-3.40)以及细菌感染(HR,2.38;95% CI,1.23-4.58)风险增加,但抗TNF单药治疗患者的机会性病毒感染风险较低(HR,0.57,95% CI,0.38-0.87)。

研究发现炎症性肠病患者不同免疫抑制方案治疗导致的严重和机会性感染风险存在较大差异,在临床实践过程中需仔细权衡不同治疗方案的治疗收益。

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    2018-07-18 许安
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    2018-04-20 哈哈869

    学了

    0

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    2018-04-19 121832a9m88暂无昵称

    学习了

    0

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  7. [GetPortalCommentsPageByObjectIdResponse(id=1711450, encodeId=32a71e1145006, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Feb 19 05:20:00 CST 2019, time=2019-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064363, encodeId=d7842064363d6, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sat Feb 09 10:20:00 CST 2019, time=2019-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072131, encodeId=b6db20e21319b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 18 12:20:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307417, encodeId=790030e41707, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Apr 20 04:54:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307096, encodeId=dc8030e09678, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Thu Apr 19 05:25:33 CST 2018, time=2018-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407183, encodeId=7016140e18346, content=<a href='/topic/show?id=4128290361f' target=_blank style='color:#2F92EE;'>#免疫抑制治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29036, encryptionId=4128290361f, topicName=免疫抑制治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffd62597391, createdName=liye789132252, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504401, encodeId=f5be150440115, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547133, encodeId=d877154e133b6, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306323, encodeId=c8aa30632313, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Mon Apr 16 12:34:26 CST 2018, time=2018-04-16, status=1, ipAttribution=)]
  8. [GetPortalCommentsPageByObjectIdResponse(id=1711450, encodeId=32a71e1145006, content=<a href='/topic/show?id=9a1c289680' target=_blank style='color:#2F92EE;'>#AST#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2896, encryptionId=9a1c289680, topicName=AST)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8b9831894722, createdName=ms24272190615788285182, createdTime=Tue Feb 19 05:20:00 CST 2019, time=2019-02-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2064363, encodeId=d7842064363d6, content=<a href='/topic/show?id=94ffe853a7' target=_blank style='color:#2F92EE;'>#Gastroenterol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7853, encryptionId=94ffe853a7, topicName=Gastroenterol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0bed488, createdName=jktdtl, createdTime=Sat Feb 09 10:20:00 CST 2019, time=2019-02-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2072131, encodeId=b6db20e21319b, content=<a href='/topic/show?id=9d4ee84647' target=_blank style='color:#2F92EE;'>#GAS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7846, encryptionId=9d4ee84647, topicName=GAS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e2dd327, createdName=许安, createdTime=Wed Jul 18 12:20:00 CST 2018, time=2018-07-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307417, encodeId=790030e41707, content=学了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTKcmgibQ4oCrK7Z6f4CvMcs4k7QUGCkhopcGxvxaBfVciadECSIwaRVttllIOEKumpEaRrq5PoOUxow/0, createdBy=e3bb2081203, createdName=哈哈869, createdTime=Fri Apr 20 04:54:16 CST 2018, time=2018-04-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=307096, encodeId=dc8030e09678, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f22260741, createdName=121832a9m88暂无昵称, createdTime=Thu Apr 19 05:25:33 CST 2018, time=2018-04-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1407183, encodeId=7016140e18346, content=<a href='/topic/show?id=4128290361f' target=_blank style='color:#2F92EE;'>#免疫抑制治疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=29036, encryptionId=4128290361f, topicName=免疫抑制治疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ffd62597391, createdName=liye789132252, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1504401, encodeId=f5be150440115, content=<a href='/topic/show?id=7730e85412' target=_blank style='color:#2F92EE;'>#Gastroenterology#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7854, encryptionId=7730e85412, topicName=Gastroenterology)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5fc29706655, createdName=chaojitidian, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1547133, encodeId=d877154e133b6, content=<a href='/topic/show?id=4ef26e01766' target=_blank style='color:#2F92EE;'>#炎症性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=67017, encryptionId=4ef26e01766, topicName=炎症性)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=09e813968720, createdName=12498dd9m15暂无昵称, createdTime=Wed Apr 18 02:20:00 CST 2018, time=2018-04-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=306323, encodeId=c8aa30632313, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfBfgWn9nXBgH1sNSiaOAKhsKpN40jDHQKqcRzovau5VibLvREN8uxnu9sKoScBicHSiaDMmbveibFdrBiaD4k4IOPwlG/0, createdBy=b5d11730951, createdName=Jackie Li, createdTime=Mon Apr 16 12:34:26 CST 2018, time=2018-04-16, status=1, ipAttribution=)]
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    2018-04-16 Jackie Li

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近日,匈牙利研究人员报告,炎症性肠病(IBD)患者使用类固醇治疗后,其静脉血栓栓塞事件的风险增加,但使用生物疗法者并非如此。