摘要
炎症性肠病(IBD)与风湿免疫病的发病均存在机体的异常免疫应答。全基因组关联研究发现,IBD与某些风湿免疫病存在遗传学重叠,提示可能存在共同的发病机制。IBD患者合并风湿免疫病的风险较正常人群增加,为诊治带来挑战。当IBD患者合并脊柱关节炎、类风湿关节炎、系统性红斑狼疮、干燥综合征、血管炎、系统性硬化等风湿免疫疾病时,诊断需全面,处理具有特殊性,尽量选用能覆盖两种疾病的药物,或根据二者严重度及活动度行个体化治疗,尽量规避治疗一种疾病但会加重另一种疾病的药物,消化科医生应与风湿科医生合作,采用多学科诊疗模式,为患者制定最佳治疗方案。本文总结了IBD合并常见风湿免疫病的诊疗策略,以期为临床工作提供参考。
Both inflammatory bowel disease(IBD)and rheumatic immune diseases have abnormal immune response.Genome-wide association studies have found that there is genetic overlap between IBD and certain rheumatic immune diseases,suggesting that there may be a common pathogenesis.The risk of rheumatic immune disease in IBD patients is higher than that of normal population,which brings challenges for diagnosis and treatment.When IBD patients are complicated with rheumatic immune diseases including spinal arthritis,rheumatoid arthritis,systemic lupus erythematosus,Sjögren′s syndrome,vasculitis and systemic sclerosis,the diagnosis should be comprehensive and the treatment should be specific.Drugs that can cover the two diseases should be selected as far as possible,or individualized treatment should be carried out according to the severity and activity of the two diseases.It is suggested to avoid drugs that treat one disease but increase the risk of another.Therefore,gastroenterologists should cooperate with rheumatologists,and adopt multidisciplinary diagnosis and treatment mode to formulate the best treatment plan for patients.This paper summarizes the diagnosis and treatment strategies of IBD complicated with common rheumatic immune diseases,in order to provide references for clinical work.
作者
祖晓满
徐舒
林丽慧
冯瑞
陈白莉
陈旻湖
何瑶
Zu Xiaoman;Xu Shu;Lin Lihui;Feng Rui;Chen Baili;Chen Minhu;He Yao(Department of Gastroenterology,The First Affiliated Hospital,Sun Yat-sen University,Guangzhou 510080,China)
出处
《中华炎性肠病杂志（中英文）》
2021年第1期21-26,共6页
Chinese Journal of Inflammatory Bowel Diseases
基金
国家自然科学基金(81670607)。
关键词
炎症性肠病
风湿免疫病
脊柱关节炎
类风湿关节炎
系统性红斑狼疮
诊断
治疗
Inflammatory bowel disease
Rheumatic immune disease
Spinal arthritis
Rheumatoid arthritis
Systemic lupus erythematosus
Diagnosis
Treatment
