英夫利西单抗联合硫唑嘌呤治疗炎症性肠病的临床研究进展

Clinical Research Progress of Infliximab Combined with Azathioprine in the Treatment of Inflammatory Bowel Disease

摘要: 炎症性肠病(Inflammatory bowel disease, IBD)是一种胃肠道的慢性炎症性疾病，其发病机制复杂，与遗传易感宿主对环境触发因素的免疫反应失调有关，具有终生复发倾向。常规用药包括5-氨基水杨酸、糖皮质激素、免疫抑制剂等，这些药物虽然有一定的临床疗效，但是依然很难阻挡疾病的进展。生物制剂的应用为炎症性肠病的治疗带来了转机。然而，单一的生物制剂效果有限。越来越多的研究证实了生物制剂联合免疫抑制剂与单一生物制剂治疗相比在改善应答率、提高缓解率、降低炎症、促进黏膜愈合、降低输液反应等方面的优势。但两者的联合也会增加感染及恶性肿瘤的风险。本文旨在对英夫利西单抗联合硫唑嘌呤在炎症性肠病治疗中的疗效及安全性作一综述。

Abstract: Inflammatory bowel disease (IBD) is a chronic inflammatory disease of the gastrointestinal tract that has a complex pathogenesis and is associated with dysregulated immune responses to envi-ronmental triggers in genetically susceptible hosts and has a lifelong tendency to relapse. Conven-tional drugs include 5-aminosalicylic acid, glucocorticoids, immunosuppressive agents, etc. Alt-hough these drugs have certain clinical efficacy, it is still difficult to block the progression of the disease. The use of biologics has brought a turn in the treatment of inflammatory bowel disease. However, single biologics have limited efficacy. An increasing number of studies have confirmed the advantages of biologics combined with immunosuppressive agents compared with single biologics in improving response rate, improving remission rate, reducing inflammation, promoting mucosal healing, and reducing infusion reactions. However, the combination of the two also increases the risk of infection and malignancy. The aim of this paper is to review the efficacy and safety of inflixi-mab combined with azathioprine in the treatment of inflammatory bowel disease.