炎性肠病并发机会性感染及其对预后的影响  

Opportunistic infections in inflammatory bowel disease and its impact on prognosis

作　　者：杨红 金梦[2] 张慧敏[2] 柏小寅[2] 王征 陈轩馥 武美序 国明月 钱家鸣 李辉[1] 王丽[1] YANG Hong;JIN Meng;ZHANG Hui-min;BAI Xiao-yin;WANG Zheng;CHEN Xuan-fu;WU Mei-xu;GUO Ming-yue;QIAN Jia-ming;LI Hui;WANG Li(Department of Epidemiology and Biostatistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing 100005,China;Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences,& Peking Union Medical College, Beijing 100730, China)

机构地区：[1]中国医学科学院基础医学研究所北京协和医学院基础学院流行病学系,北京100005 [2]中国医学科学院北京协和医学院北京协和医院消化科,北京100730

出　　处：《中华临床免疫和变态反应杂志》2019年第2期104-107,共4页Chinese Journal of Allergy & Clinical Immunology

基　　金：国家自然科学基金(81570505);国家科技部支撑计划课题973(2015CB943203);公益性行业科研专项(201002020,201502005);中国医学科学院医学与健康科技创新工程基金(CIFMS,2016-12M-3-001)~~

摘　　要：目的分析机会性感染在溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD)中的分布情况及对疾病预后的影响。方法本研究为基于医院电子数据库系统的回顾性研究,纳入1985年至2015年北京协和医院收治的UC和CD患者。预后危险因素采用多因素Logistic回归分析。结果共1467例患者纳入研究,UC患者898例,CD患者569例。巨细胞病毒(cytomegalovirus,CMV)为UC和CD患者最常见机会性感染病原体(住院感染率分别为6.5%和1.2%),UC患者CMV感染和艰难梭菌感染的概率显著高于CD患者(6.5%vs. 1.2%,P<0.001;1.7%vs. 0.4%,P<0.05)。CMV感染是UC患者手术的独立危险因素(OR=2.84,95%CI:1.41~5.69,P<0.05)。结论 CMV是炎性肠病最常见的机会性感染且会增加UC手术风险,临床需加强对机会性感染的早期识别和干预。Objective To describe opportunistic infections in patients with ulcerative colitis (UC) and Crohn s disease (CD) in order to evaluate its effect on prognosis. Methods This was a retrospective study which based on hospital electronic database. Patients diagnosed with UC or CD treated in Peking Union Medical College Hospital from 1985 to 2015 were enrolled. Multivariate Logistic regression analysis was used to evaluate risk factors for prognosis. Results A total of 1467 patients were included, in which 898 patients were diagnosed as UC and 569 as CD. Cytomegalovirus (CMV) was the most common opportunistic infection in all the patients with UC and CD (infection rate in hospital is 6.5% and 1.2%, respectively). The incidence of CMV infection and clostridium difficile infection in UC was significantly higher than that in CD(6.5% vs. 1.2%, P < 0.001;1.7% vs. 0.4%, P <0.05).CMV was an independent risk factor for surgery in patients with UC( OR =2.84,95% CI :1.41~5.69, P <0.05). Conclusions CMV is the most common hospital opportunistic infection in patients with inflammatory bowel diseases and is an independent risk factor for prognosis of UC patients who underwent surgeries. Opportunistic infection in patients with UC and CD calls for early detection and intervention.

关 键 词：溃疡性结肠炎 克罗恩病 机会性感染 巨细胞病毒 

分 类 号：R574[医药卫生—消化系统]