结缔组织病合并结核病的研究进展

doi:10.19983/j.issn.2096-8493.20220011

摘要/Abstract

摘要：

结缔组织病是引起多系统功能障碍的自身免疫病,结核病是危害人民生命健康的重要传染病。结缔组织病患者患结核病风险较一般人群高,其临床表现不典型,诊疗难度大,且预后差。作者针对结缔组织病合并结核病的流行状况、危险因素、临床特点、筛查与治疗策略进行综述,为结缔组织病合并结核病的筛查、预防和控制提供最新的研究进展。

关键词: 结缔组织疾病, 结核, 共病现象, 综述文献(主题)

Abstract:

Connective tissue diseases (CTD) are heterogeneous autoimmune diseases with the potential to affect multiple body systems, while tuberculosis is an important infectious disease that endangers people’s lives and health in China. Patients with CTD have a higher risk of tuberculosis than the general population, with atypical clinical manifestations, difficult diagnosis and treatment, and poor prognosis. Therefore, we draft a review of the prevalence, risk factors, clinical characteristics, screening and therapeutic strategies of CTD complicated with tuberculosis, to provide readers with the latest progress on its screening, prevention and management.

Key words: Connective tissue disease, Tuberculosis, Comorbidity, Review literature as topic

中图分类号:

郦源, 郭茹茹, 吕良敬. 结缔组织病合并结核病的研究进展[J]. 结核与肺部疾病杂志, 2022, 3(4): 309-314. doi: 10.19983/j.issn.2096-8493.20220011

Li Yuan, Guo Ruru, Lyu Liangjing. Research progress of connective tissue disease and tuberculosis comorbidity[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(4): 309-314. doi: 10.19983/j.issn.2096-8493.20220011

图/表 3

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方案	具体用药	优先级	推荐强度^a	证据级别
3H-P	12周每周1次RPT+INH联合治疗	首选	强烈推荐	中等
4R	4个月每日RFP单药治疗	首选	强烈推荐	中等^b
3H-R	3个月每日RFP+INH联合治疗	首选	有条件推荐	低^c
6H	6个月每日INH单药治疗	替代	有条件推荐^d	中等

疾病活动度	评判指标^a	治疗建议
低	SLEDAI ≤6分或DAS28<3.2分	非甾体类抗炎药、镇痛药、小剂量GC、低风险的csDMARD(如羟氯喹、柳氮磺吡啶)
中	SLEDAI 7~12分或DAS28 3.3~5.0分	小剂量GC加csDMARD,或2种csDMARD联用,但必须在完成2H-R-Z-E^b诱导治疗后方可接受甲氨蝶呤、环孢素、硫唑嘌呤等免疫抑制剂
高	SLEDAI >12分或DAS28>5.1分	可在完成2H-R-Z-E诱导治疗后选择低风险的生物制剂如利妥昔单抗、托珠单抗、阿巴西普、阿那白滞素,以上均无反应者可尝试依那西普