炎症性肠病患者患带状疱疹的风险增高
炎症性肠病是累及回肠、结肠、直肠的肠道疾病，通常临床上指的就是溃疡性结肠炎（UC）和结肠克罗恩病（IBD）。它们的临床表现是腹痛、腹泻，血便，因病因不明，一般采用皮质类固醇激素类药物、抗肿瘤坏死因子药物及硫代嘌呤类药物等对症治疗。
临床发现炎症性肠病患者使用这些药物治疗后，患带状疱疹的风险增加，为确认这两种疾病的关联性，及是否与应用上述药物有关，来自美国的Long医生和同事对既往采用上述药物治疗的炎症性肠病患者进行了回顾性大规模队列研究。该研究在线发表于2012年12月13日《《营养药理学与治疗学（Aliment Pharmacol Ther）》杂志上。
队列包括50932名IBD患者，56403名UC患者和1269名非特异性炎症性肠病患者，他们与434416名非IBD患者相匹配，采用条件logistic回归方法比较两组之间发生带状疱疹的关联性。结果显示，与非IBD患者相比，IBD患者患带状疱疹的风险增高，抗肿瘤坏死因子药物、皮质类固醇激素、硫代嘌呤类药物的使用与带状疱疹的发生明显相关，其中使用抗肿瘤坏死因子药物和硫代嘌呤药物患带状疱疹的风险最高。
爱爱医评论：带状疱疹由水痘带状疱疹病毒引起，属机会致病性病毒，在机体免疫力正常时在神经根内“休眠”，当机体受到外界刺激，免疫力低下的时候，病毒就被激活从而引起疾病。免疫抑制剂是一把双刃剑，在达到疾病治疗效果的同时，其免疫抑制的副作用也可能展现出来。在采用免疫抑制治疗的时候，需密切注意用药反应，还可通过增加营养，锻炼身体等方式提高机体抵抗力。
Increased risk of Herpes zoster among 108 604 patients with inflammatory bowel disease
M. D. Long, C. Martin, R. S. Sandler,M. D. Kappelman
Background: Patients with inflammatory bowel disease (IBD) on certain immunosuppressants have increased herpes zoster (HZ) risk.
Aim: To determine the risk of HZ in IBD and how antitumour necrosis factor-alpha (anti-TNF) agents affect this risk.
Methods: We performed a retrospective cohort and nested case–control study using administrative data from IMS LifeLink® Information Assets-Health Plan Claims Database. In the cohort, we identified IBD patients <age 64 by diagnosis codes; matched to four individuals without IBD. HZ risk was evaluated by incidence rate ratio (IRR) and adjusted Cox proportional hazards models (HR). In the nested case–control analysis, 2659 IBD patients with HZ were each matched to four IBD patients without HZ. We determined associations between medications and HZ using conditional logistic regression.
Results: The cohort included 50 932 patients with Crohn's disease (CD), 56 403 patients with ulcerative colitis (UC) and 1269 with unspecified IBD, matched to 434 416 individuals without IBD. The IBD cohort had increased HZ risk compared with non-IBD (IRR: 1.68, 95% CI: 1.60–1.76). After adjustment, IBD patients had a higher risk of HZ than non-IBD (HR: 1.49, 95% CI: 1.42–1.57). In the nested case–control multivariate-adjusted analyses, anti-TNF medications (OR: 1.81, 95% CI: 1.48–2.21), corticosteroids (OR: 1.73, 95% CI: 1.51–1.99) and thiopurines (OR: 1.85, 95% CI: 1.61–2.13) were independently associated with HZ. Risk of HZ was highest with combination anti-TNF and thiopurine therapy (OR: 3.29, 95% CI: 2.33–4.65).
Conclusions: Patients with inflammatory bowel disease are at increased risk for herpes zoster. Use of thiopurines, anti-TNF agents, combination therapy and corticosteroids increases herpes zoster risk.
本站所注明来源为"爱爱医"的文章，版权归作者与本站共同所有，非经授权不得转载。
本站所有转载文章系出于传递更多信息之目的，且明确注明来源和作者，不希望被转载的媒体或个人可与我们
联系zlzs@120.net，我们将立即进行删除处理
热点图文
-
沙红英博士：核移植技术实现线粒体遗传病患者健**殖
随着时代的进步，高龄孕妇队伍逐渐庞大。顺应时代需求， 生育治疗技术也在不断...[详细]
-
推进POCT网络化管理 提升其在院内质量管理水平
床旁检测是包括急救医学和重症医学在内的急诊医学发展到一定阶段的产物，其快速...[详细]
