结核病在类风湿性疾病患者中的进展 - - 系统性审查和元分析
Karthikeyan Sundaram1, Leela Kagithakara Vajravelu1, Ravichandiran Velayutham2
1Department of Microbiology, SRM Medical College Hospital and Research Centre, Kattangulathur, Chennai, 603203, Tamilnadu, India.
The Indian journal of tuberculosis
|June 15, 2025
概括
在自身免疫性疾病患者中,结核病的风险较高,特别是那些服用免疫抑制剂 (如抗TNF-α疗法) 的患者. 这一系统性审查强调需要在这些脆弱人群中仔细监测和管理结核病.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 类风湿病学 类风湿病学
背景情况:
- 结核病 (TB) 是全球领先的传染病杀手,由结核菌菌引起.
- 患有自身免疫性疾病的患者往往面临更高的结核病风险,尤其是在接受抗瘤坏死因子-α (抗-TNF-α) 治疗时.
- 了解自身免疫性疾病患者的结核病风险因素对于有效管理至关重要.
研究的目的:
- 系统地审查和分析最近关于肺结核发病率和自身免疫性疾病患者的风险因素的研究.
- 评估免疫抑制疗法对从潜伏性结核病向活跃性结核病的进展的影响.
主要方法:
- 按照优先报告项目和系统审查和元分析 (PRISMA) 准则进行的系统审查.
- 分析包括资格标准,搜索策略,批判性评估和干预方法.
- 数据综合侧重于结核病发病率和各种自身免疫性疾病中的相关风险因素.
主要成果:
- 结核病发病率观察到系统性红斑狼 (SLE) 的3.25%和类风湿性关节炎 (RA) 患者的4.54%.
- 在多发性硬化症 (MS) 患者中记录了1.9%的结核病例的显著发病率.
- 疾病修饰性抗风湿药物 (DMARD) 和免疫抑制治疗,特别是抗TNF-α抑制剂,被确定为生物原始患者结核病的主要风险因素.
结论:
- 从潜伏性结核病到活跃性结核病的进展在接受免疫抑制剂治疗的自身免疫性疾病患者中显著增加,例如葡萄糖皮质类药物,阿扎西奥普林,普雷尼松和莱夫卢诺米德.
- 免疫抑制疗法,包括DMARD和抗TNFα抑制剂,是这一群体结核病发展的关键风险因素.
- 本次审查强调了针对接受免疫抑制治疗的自身免疫性疾病患者进行主动性结核病查和管理策略的重要性.
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