Ψһ³¦µÀÑ¡ÔñÐÔÉúÎïÖƼÁ°²¼ªÓÅ»ñÅú½øÈëÖйú
ÉϺ£2020Äê3ÔÂ13ÈÕ /ÃÀͨÉç/ -- ÎäÌïÖйúÐû²¼Ò»¿îȫлúÖƵÄÈËÔ´»¯³¦µÀÑ¡ÔñÐÔÉúÎïÖƼÁ°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©£¬»ñµÃ¹ú¼ÒÒ©Æ·¼à¶½¹ÜÀí¾Ö£¨NMPA£©Åú×¼Õýʽ½øÈëÖйú£¬»ñÅúÊÊӦ֢Ϊ¶Ô´«Í³ÖÎÁÆ»òÖ×Áö»µËÀÒò×Ó¦Á£¨TNF¦Á£©ÒÖÖƼÁÓ¦´ð²»³ä·Ö¡¢Ê§Ó¦´ð»ò²»ÄÍÊܵÄÖÐÖضȻÐÔÀ£ÑñÐԽ᳦Ñ׺ͿËÂÞ¶÷²¡µÄ³ÉÄ껼Õß¡£°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©ÊÇÄ¿Ç°Ñ×Ö¢ÐÔ³¦²¡£¨IBD£©ÁìÓòΨһµÄ³¦µÀÑ¡ÔñÐÔÉúÎïÖƼÁ£¬ÆäÁÙ´²Êý¾Ý±íÃ÷Äܹ»¿ìËÙÆðЧ [1],[2],[3]£¬²¢ÊµÏÖ³¤Æڳ־õÄÁÙ´²»º½âºÍð¤Ä¤ÓúºÏ [4],[5]£¬Í¬Ê±°²È«ÐԺà [6]£¬ÊÇÅ·ÃÀ¹ú¼ÊÖ¸ÄÏÍƼöµÄÒ»ÏßÉúÎïÖƼÁ [7],[8]¡£
°²¼ªÓÅ£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©
°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©±»ÁÐÈëµÚÒ»ÅúÁÙ´²¼±Ðè¾³ÍâÐÂÒ©Ãûµ¥£¬»ñµÃ¼Ó¿ìÉóÆÀ¡£´ËÍ⣬2019Äê9Ô¡¶ÐÂÓ¢¸ñÀ¼Ò½Ñ§ÔÓÖ¾¡·£¨NEJM£©·¢±íÁËIBDÁìÓò¾ßÓл®Ê±´úÒâÒåµÄÊ׸öÉúÎïÖƼÁÍ·¶ÔÍ·±È½ÏµÄÁÙ´²Ñо¿VARSITY£¬ÕâÊÇÒ»ÏîÕë¶ÔÖÐÖضȻÐÔÀ£ÑñÐԽ᳦Ñ×»¼ÕßµÄËæ»ú¡¢Ë«Ã¤¡¢Ë«Ä£Ä⡢ȫÇò¶àÖÐÐĵÄIIIbÆÚÑо¿¡£¸ÃÑо¿ÏÔʾ£¬µÚ52ÖܵÄÁÙ´²»º½âºÍճĤÓúºÏ£¬°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©¾ùÏÔÖøÓÅÓÚ°¢´ïľµ¥¿¹[9]¡£
ÖлªÒ½Ñ§»áÏû»¯²¡Ñ§·Ö»áÖ÷ÈÎίԱ³Â?Fºþ½ÌÊÚ±íʾ£º¡°³ýÁËVARSITYÑо¿Í⣬ÉÏÊÐÒÔÀ´È«Çò¶àÏîÕæʵÊÀ½çÑо¿½á¹ûÖ¤Ã÷άµÃÀûÖéµ¥¿¹ÔÚ¿ËÂÞ¶÷²¡ºÍÀ£ÑñÐԽ᳦Ñ×µÄÖÎÁÆÖоßÓÐÁÆЧºÃ¡¢°²È«ÐԸߵÄÌص㡣άµÃÀûÖéµ¥¿¹×÷ΪÌØÒìÐÔÑ×֢ϸ°ûÒƶ¯ÒÖÖƼÁ£¬ÔÚÓÕµ¼¼°Î¬³ÖIBDÖ¢×´»º½â¡¢´ïµ½ð¤Ä¤ÓúºÏÄ¿±ê¡¢Ìá¸ß»¼ÕßÉú»îÖÊÁ¿·½Ãæ¾ßÓÐÓÅÊÆ£¬ÎªÖÐÖضÈÑ×Ö¢ÐÔ³¦²¡»¼ÕßµÄÖÎÁÆÌṩÁËеÄÑ¡Ôñ¡£¡±
Ñ×Ö¢ÐÔ³¦²¡£¨IBD£©ÊÇÒ»ÖÖ²¡ÒòÉÐδÃ÷È·µÄÂýÐÔ¡¢·ÇÌØÒìÐÔ³¦µÀÑ×Ö¢ÐÔ¼²²¡£¬Ö÷Òª°üÀ¨À£ÑñÐԽ᳦Ñ×£¨UC£©ºÍ¿ËÂÞ¶÷²¡£¨CD£©£¬ÊÇÒ»ÖÖÂýÐÔ¡¢½øÕ¹ÐÔ¡¢·´¸´·¢×÷µÄ¼²²¡[10]¡£Ô¤¼Æµ½2025Ä꣬ÎÒ¹úµÄIBD»¼Õß½«´ïµ½150ÍòÈË[11],[12]¡£Ä¿Ç°ÓÃÓÚÖÎÁÆÖÐÖضÈÑ×Ö¢ÐÔ³¦²¡µÄ·½°¸ÓÐÌÇƤÖʼ¤ËØ¡¢ÃâÒßÒÖÖƼÁºÍÖ×Áö»µËÀÒò×Ó£¨TNF-¦Á£©ÒÖÖƼÁ[10]£¬µ«»¼ÕßÖÎÁÆÈÔ²»´ï±ê[10],[13],[14]¡£
°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©¿ÉÓë±í´ïÔÚ¼ÇÒäTÁÜ°Íϸ°û±íÃæµÄ¦Á4¦Â7ÕûºÏËØÌØÒìÐÔ½áºÏ£¬×è¶Ï¦Á4¦Â7ÕûºÏËØÓëճĤµØÖ·ËØϸ°ûÕ³¸½·Ö×Ó-1£¨MAdCAM-1£©Ï໥×÷Óã¬ÒÖÖƼÇÒäTÁÜ°Íϸ°ûǨÒÆÖÁ³¦µÀµÄÑ×Ö¢×éÖ¯£¬´Ó¶ø¼õÉÙ³¦µÀð¤Ä¤Ñ×Ö¢£¬ÎªIBD»¼ÕßÌṩÁ˾«×¼³¦µÀÑ¡ÔñµÄÈ«ÐÂÖÎÁÆ·½°¸[15]¡£
ÎäÌïÖйú×ܲõ¥¹úºéÏÈÉú±íʾ£º¡°·Ç³£¸Ðл¹ú¼ÒÒ©Æ·¼à¶½¹ÜÀí¾ÖÕýʽÅú×¼°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©½øÈëÖйúÊг¡¡£°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©µÄÉÏÊв»½öΪÁÙ´²Ò½Éú´øÀ´¸ü¶àµÄÖÎÁÆÑ¡Ôñ£¬¸üÄÜ°ïÖúIBD»¼ÕßÖػذ²ÎȵÄ×ÔÓÉÉú»î¡£´Ó°²¼ªÓÅ ®£¨×¢ÉäÓÃάµÃÀûÖéµ¥¿¹£©ÄÉÈëµÚÒ»ÅúÁÙ´²¼±Ðè¾³ÍâÐÂÒ©Ãûµ¥µ½ËüµÄ¿ìËÙ»ñÅú£¬Õâ³ä·ÖÏÔʾÁËÖйúÕþ¸®¼ÓËÙÒýÈë´´ÐÂÒ©Îï¡¢²»¶ÏÌá¸ßÈËÃñ½¡¿µÉú»îµÄ¾öÐÄ¡£±ü³Ö×Å»¼ÕßΪÏȵÄÀíÄÎäÌｫ¼ÌÐøÖÂÁ¦ÓÚÑз¢¸ß¶È´´ÐÂÒ©ÎïºÍÍ»ÆÆÐÔÁÆ·¨£¬°Ñ¸ü¶àµÄ´´ÐÂÒ©Æ·¸ü¿ìµÄÒýÈëÖйú£¬¹²Öþ¡®½¡¿µÖйú2030¡¯¡£¡±
×÷Ϊһ¼ÒÒÔ¼ÛÖµ¹ÛΪ»ù´¡¡¢ÒÔÑз¢ÎªÇý¶¯µÄÈ«ÇòÁìÏÈÉúÎïÖÆÒ©¹«Ë¾£¬ÎäÌïרעÓÚÔÚÖ×Áö¡¢Ïû»¯¡¢Éñ¾¿Æѧ¼°º±¼û²¡ËÄ´ó¼²²¡ÁìÓòµÄÒ©ÎïÑз¢£¬²¢Õë¶ÔѪҺÖÆÆ·¼°ÒßÃçÁìÓò½øÐÐרÏîÑз¢Í¶È롣ƾ½èÔÚÏû»¯ÁìÓòÑз¢ÊµÁ¦ºÍÁìÏȵØ룬ÎäÌï×Ô1994Äê½øÈëÖйúÒÔÀ´£¬Ê¼ÖÕ»ý¼«Íƶ¯²¢²ÎÓëÖйúÏû»¯ÁìÓò¿ÆÑкÍÕïÁƵijÖÐø·¢Õ¹£¬²»¶Ï¼ùÐпÆѧ´´ÐµľöÐļ°Ô츣»¼ÕߵijÐŵ¡£
1.Feagan B, et al. United European Gastroenterol J. 2017;5:A40 (abstract OP097) |
2.Feagan BG, et al. N Engl J Med 2013;369:699-710 |
3.Feagan B, et al. Clin Gastroenterol Hepatol doi:10.1016/j.cgh.2018.05.026 |
4.Arijs I, et al. Gut 2018;67:43-52 |
5.Danese S et al. Gastroenterology. 2019 Oct; 157(4):1007-1018.e7 |
6.Click B, Regueiro M. Inflamm Bowel Dis. 2019 Apr 11;25(5):831-842. |
7.Harbord M , Eliakim R , Bettenworth D , et al. Third European Evidence-based Consensus on Diagnosis and Management of Ulcerative Colitis. Part 2: Current Management[J]. Journal of Crohn¡¯s and Colitis, 2017. |
8.Rubin D T , Ananthakrishnan A N , Siegel C A , et al. ACG Clinical Guideline: Ulcerative Colitis in Adults[J]. The American Journal of Gastroenterology, 2019, 114(3):1. |
9.Sands B, Peyrin-Biroulet L, Loftus E, et al. Vedolizumab versus adalimumab for moderate to severe ulcerative colitis. N Engl J Med. 2019. |
10.ÖлªÒ½Ñ§»áÏû»¯²¡Ñ§·Ö»áÑ×Ö¢ÐÔ³¦²¡Ñ§×é. Ñ×Ö¢ÐÔ³¦²¡Õï¶ÏÓëÖÎÁƵĹ²Ê¶Òâ¼û(2018Äꡤ±±¾©)[J]. ÖйúʵÓÃÄÚ¿ÆÔÓÖ¾, 2018(9). |
11.ѦÁÖÔÆ, Å·ÑôÇÕ, »ÆÖлª, et al. ½ü20ÄêÖйúIBDÑо¿½øÕ¹¡ª¡ª20ÄêÎÄÏ××ܽá[J]. ¹ú¼ÊÏû»¯²¡ÔÓÖ¾(4):63-65. |
12.Danese S et al. Gastroenterology. 2015 |
13.Àîèª, µË³¤Éú, ÕÔÇï. ÃâÒßÒÖÖƼÁÖÎÁÆIBDµÄ²»Á¼·´Ó¦¼°¶Ô²ß[J]. ҽѧÐÂÖª, 2015(4):219-222. |
14.¿¹Ö×Áö»µËÀÒò×Ó¦Áµ¥¿Ë¡¿¹ÌåÖÎÁÆÑ×Ö¢ÐÔ³¦²¡×¨¼Ò¹²Ê¶£¨2017£©.кÍҽѧÔÓÖ¾.2017;8(4-5):239-43 |
15.°²¼ªÓÅ ®ËµÃ÷Êé |
ÉÏһƪ£ºÍø¿Î²»µÈÓÚÉÏÍøÉÏ¿Î ÇáÇáÔÚÏß¡°ÎåºÃ¡±½ÌѧÀíÄîÌáÉý¿ÎÌÃЧ¹û
ÏÂһƪ£º×îºóÒ»Ò³
¹óÖÝÀúÊ·
¹óÖÝÀúÊ·
¹óÖÝÀúÊ·
QQ¹«ÖںŹØ×¢
ÐÂÀË΢²©¹Ø×¢
΢ÐźÅ:dd_gzw
¹¤ÉÌÍø¼à
³£ÎñÀíÊÂ
¹«°²±¸°¸
¹¤ÐŲ¿±¸°¸
°²È«ÁªÃË
ʵÃûÈÏÖ¤