摘要
风湿性疾病作为一类常见的自身免疫性疾病,治疗上经常使用糖皮质激素、免疫抑制剂、生物制剂和小分子靶向药物等,这些药物的应用往往会导致患者自身免疫功能异常,致使其具有较高的LTBI发生风险,且发展为活动性结核病的风险也显著增加。因此,在临床工作中,需要对符合筛查条件的风湿性疾病患者进行LTBI筛查。这就要求风湿免疫科医师和结核科医师加强协作,提高意识,针对需要进行LTBI筛查的风湿性疾病患者进行科学评估,制定规范的筛查流程和预防性治疗方案,以防范风湿性疾病患者合并LTBI后发展为活动性结核病。基于此,国家感染性疾病临床医学研究中心/深圳市第三人民医院、北京大学深圳医院、中国医学科学院北京协和医院、中国防痨协会、《中国防痨杂志》编辑委员会和深圳市炎症与免疫性疾病重点实验室共同组织国内结核病和风湿性疾病领域专家撰写了《风湿性疾病患者合并结核分枝杆菌潜伏感染诊治的专家共识》(简称“共识”)。本共识基于我国风湿性疾病患者合并LTBI的流行病学、循证医学证据和临床研究等方面数据,经过多次研讨并达成一致意见,供同道参考借鉴。
Rheumatic diseases are autoimmune diseases that occur when an individual’s immune system mistakenly attacks healthy tissues,and are often treated with glucocorticoids,immunosuppressants,biological agents,and small-molecule targeted drugs,etc.,which can lead to an increased risk of other autoimmune dysfunctions in patients and the activation of latent tuberculosis infection(LTBI).Therefore,LTBI screening in clinical is essential for patients with rheumatic diseases who meet the screening criteria.This requires greater collaboration and awareness between rheumatologists and tuberculosis physicians,to conduct scientific assessment for patients with rheumatic diseases who need LTBI screening,and to develop preventive treatment guidelines to prevent patients with rheumatic diseases from developing active tuberculosis after LTBI.Therefore,the National Clinical Research Centre for Infectious Disease/The Third People’s Hospital of Shenzhen,Peking University Shenzhen Hospital,Peking Union Medical College Hospital of Chinese Academy of Medical Sciences,Chinese Antituberculosis Association,Editorial Board of Chinese Journal of Antituberculosis and Shenzhen Key Laboratory of Inflammatory and Immune Diseases joint effort in the publication of an expert consensus on the diagnosis and treatment of LTBI in patients with rheumatic diseases.This consensus is based on the epidemiology,evidence-based medicine,and clinical research of rheumatic diseases complicated with LTBI,and has been discussed for many times and reached consensus.It can serve as a reference.
作者
国家感染性疾病临床医学研究中心/深圳市第三人民医院
北京大学深圳医院
中国医学科学院北京协和医院
中国防痨协会
《中国防瘠杂志》编辑委员会
深圳市炎症与免疫性疾病重点实验室
邓国防
王庆文
陈秋奇
吴文琪
钟剑球
赵岩
National Clinical Research Centre for Infectious Disease/The Third People’s Hospital of Shenzhen;Peking University Shenzhen Hospital;Peking Union Medical College Hospital of Chinese Academy of Medical Sciences;Chinese Antituberculosis Association;Editorial Board of Chinese Journal of Antituberculosis;Shenzhen Key Laboratory of Inflammatory and Immune Diseases;Deng Guofang;Wang Qingwen;Zhao Yan
出处
《中国防痨杂志》
CAS
CSCD
2022年第9期869-879,共11页
Chinese Journal of Antituberculosis
基金
国家自然科学基金(82070016,81974253,81901641)
广东省感染性疾病(结核病)临床医学研究中心(2020B1111170014)
广东省自然科学基金面上项目(2019A1515011112)
深圳市科技创新委员会重点基础研究项目(JCYJ20200109140203849,JCYJ20210324131813036)
深圳三名工程项目(SZSM201612009)。
关键词
风湿性疾病
分枝杆菌
结核
感染
诊断
治疗应用
Rheumatic diseases
Mycobacterium tuberculosis
Infection
Diagnosis
Therapeutic uses
