Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)37810.18786/2072-0505-2016-44-6-734-743ARTICLESОРИГИНАЛЬНЫЕ СТАТЬИSteroid resistance in inflammatory bowel diseaseГормональная резистентность при воспалительных заболеваниях кишечникаKharitonovA. G.ХаритоновА. Г.
Russian Federation

Kharitonov Andrey G. – MD, PhD, Associate Professor, Chair of Internal Diseases Propedeutics, Gastroenterology and Nutrition.

41 Kirochnaya ul., Saint Petersburg, 191015, Russian Federation. Tel.: +7 (812) 235 10 93. E-mail: mldruz@gmail.com

Харитонов Андрей Геннадьевич – кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии.

191015, г. Санкт-Петербург, ул. Кирочная, 41, Российская Федерация. Тел.: +7 (812) 235 10 93. E-mail: mldruz@gmail.commldruz@gmail.comShchukinaO. B.ЩукинаО. Б.
Russian Federation

Shchukina Oksana B. – MD, PhD, Associate Professor, Chair of Internal Diseases Propedeutics, Gastroenterology and Nutrition

Щукина Оксана Борисовна – кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии

KondrashinaE. A.КондрашинаЭ. А.
Russian Federation

Kondrashina Elina A. – MD, PhD, Associate Professor, Chair of Internal Diseases Propedeutics, Gastroenterology and Nutrition

Кондрашина Элина Александровна – кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и диетологии

North-Western State Medical University named after I.I. Mechnikov, Saint PetersburgСеверо-Западный государственный медицинский университет имени И.И. Мечникова, Санкт-Петербург150920164467347432909201629092016Copyright ©; 2016, Kharitonov A.G., Shchukina O.B., Kondrashina E.A.Copyright ©; 2016, Харитонов А.Г., Щукина О.Б., Кондрашина Э.А.2016Kharitonov A.G., Shchukina O.B., Kondrashina E.A.Харитонов А.Г., Щукина О.Б., Кондрашина Э.А.https://creativecommons.org/licenses/by/4.0https://almclinmed.ru/jour/article/view/378

Systemic glucocorticosteroids are widely used in the treatment of inflammatory bowel disease, and despite the introduction of new anti-inflammatory drugs, remain the first-line therapy for induction of remission in moderate and severe ulcerative colitis and Crohn's disease. However, in some patients steroid resistance is observed when glucocorticosteroids are not effective enough. The paper gives a detailed discussion of the criteria of steroid resistance, possible mechanisms of it's development, including secondary resistance resulting from complications of ulcerative colitis and Crohn's disease and associated opportunistic infections. Special attention is paid to the modern treatment of steroid-refractory inflammatory bowel disease.

Системные глюкокортикостероиды широко используются в терапии воспалительных заболеваний кишечника и несмотря  на появление  новых противовоспалительных препаратов остаются основным  средством   для  индукции  ремиссии при среднетяжелых  и тяжелых формах язвенного колита и болезни Крона. Тем не менее у части пациентов наблюдается гормональная резистентность,  при  которой   глюкокортикостероиды не оказывают ожидаемого  эффекта. В статье подробно рассматриваются вопросы критериев гормональной резистентности, возможные механизмы ее формирования, включая вторичную резистентность   вследствие  развития   осложнений язвенного  колита и болезни  Крона, а также присоединения оппортунистических  инфекций. Особое  внимание  уделяется  современной терапии резистентных форм воспалительных заболеваний кишечника.

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