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香港，中国 - Media OutReach - 2019年3月6日 - 在近20年间，香港克隆病的发病率大约增长了六倍，而患病率则更是上升达八倍。克隆病患者会出现持续性腹痛、腹泻、食欲不振；如累及到下段结肠或肛门直肠，还会出现粘液脓血便和里急后重。肠胃及肝脏科专科罗兆棠医生表示："克隆病的症状严重影响患者的社交和日常生活，例如无法乘车长途旅行，连到超级市场购物中途也需要去洗手间。"

新型生物制剂抑制炎症因子 助克隆病患者缓解症状

延迟确诊增加并发症风险

克隆病为炎症性肠病的一种，属免疫系统失调性疾病。15至18岁和50至60岁这两个年龄组，以及吸烟者都是高危人群。医学界正在研究克隆病的真正病因，据推测与遗传、免疫系统、环境因素及肠胃内的细菌含量等有关。罗医生说："病人携带相关遗传基因，当免疫失调，加上饮食习惯转变(例如进食高脂肪食物) 或患上肠胃炎，便有机会导致肠道共生微生物的群落结构发生改变，从而诱发克隆病。"

克隆病的症状让很多人误以为是得了痔疮或肠胃炎，因而延误求医。若没有及早治疗，病情可不断进展，最终形成肠道透壁性炎症，导致肠道狭窄和梗阻，此时患者会无法排便及持续腹痛。长期发炎也会导致瘘管形成，它们一般出现在肛门附近。肠道炎症还使身体无法正常吸收营养，因此患者一般较为瘦削。

"由上而下治疗"尽快控制病情

目前存在有多种克隆病治疗方案，以帮助不同程度病情的患者。病情中度的患者可使用口服类固醇或"肿瘤坏死因子(TNF)抑制剂"治疗。罗医生指出"TNF抑制剂"能提高缓解率，但同时又会削弱白细胞的免疫功能，增加患者感染肺结核或皮肤癌的风险。此治疗只对三分之一的患者有效，在其余三分之二的患者身上会出现继发性失效、甚至无效的情况。

近年有研究建议，病情严重的患者应采取"由上而下"(Top-down therapy)的治疗方针，即一开始就用最有效的药物如新一代生物制剂作治疗，以尽快缓解症状，降低并发症及病情恶化的风险。"白细胞介素12/23抑制剂"(例如乌司奴单抗)为新一代生物制剂，能针对特定的炎症因子抑制炎症反应，因此副作用较少，患者受感染的风险较低，效力也较持久。临床研究结果显示过半数病人能在一年后达到"缓解"状态，即指有关症状完全消失，肠道伤口得以痊愈，生活恢复正常。此新一代生物制剂的另一优势是只需三个月一次皮下注射，有助病人回归正常的日常生活。

Source http://www.media-outreach.com/release.php/View/8056#Contact