溃疡性结肠炎患者合并艰难梭菌感染的临床特征及危险因素分析  

Analysis of clinical characteristics and risk factors of Clostridium difficile infection in ulcerative colitis

作　　者：张瑞苗 尹凤荣[1] 韩菲[1] 王冬[1] 霍晓霞[1] 宋佳[1] 张红[1] 郭金波[1] 赵建宏[2] 张晓岚[1] Zhang Ruimiao;Yin Fengrong;Han Fei;Wang Dong;Huo Xiaoxia;Song Jia;Zhang Hong;Guo Jinbo;Zhao Jianhong;Zhang Xiaolan(Department of Gastroenterology,Hebei Key Laboratory of Gastroenterology,Hebei Institute of Gastroenterology,The Second Hospital,Hebei Medical University,Shijiazhuang 050000,China;Department of Laboratory,Hebei Provincial Center for Clinical Laboratories,The Second Hospital,Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院消化内科,河北省消化病重点实验室,河北省消化病研究所,石家庄050000 [2]河北医科大学第二医院检验科,河北省临床检验中心,石家庄050000

出　　处：《中华炎性肠病杂志（中英文）》2020年第3期212-216,共5页Chinese Journal of Inflammatory Bowel Diseases

摘　　要：目的:探讨溃疡性结肠炎(UC)患者艰难梭菌感染(CDI)情况,以及UC患者合并CDI的临床特征及危险因素。方法:回顾性调查2015年1月至2018年1月于河北医科大学第二医院消化内科住院诊断为UC且完成CDI筛查患者的临床资料。根据是否感染CDI将患者分为两组,分析UC合并CDI的人口学特征、临床特征等;单因素分析两组患者的临床特征;多元Logistic回归分析CDI发生的影响因素。结果:UC患者162例中,男性84例,女性78例,其中37例合并CDI,阳性率22.8%。与非CDI组相比,CDI组患者有全身应用糖皮质激素史(62.2%比25.6%,P<0.05)和应用英夫利西单克隆抗体史(13.5%比1.6%,P<0.05)比例更高。Logistic多因素分析显示,糖皮质激素是CDI感染的危险因素(OR=4.111,95%CI:1.581~9.131,P=0.001)。结论:全身应用糖皮质激素使UC患者CDI的风险增高。Objective To investigate the risk factors and clinical features of Clostridium difficile infection(CDI)in ulcerative colitis(UC)patients.Methods Clinical data of UC patients in hospital with complete CDI screening information at Department of Gastroenterology,The Second Hospital of Hebei Medical University from January 2015 to January 2018 were analyzed retrospectively.These patients were divided into two groups according to whether they were diagnosed with CDI.Demographic characteristics and clinical features of CDI in UC patients were analyzed.Univariate and multivariate analysis were used to reveal the risk factors of CDI.Result A total of 162 UC patients were enrolled in this study,including 84 males and 78 females.Thirty-seven UC patients(22.8%)were diagnosed with CDI.Compared with the non-CDI group,the CDI group had a higher proportion of patients who used glucocorticoids(62.2%vs.25.6%,P<0.05)and infliximab(13.5%vs.1.6%,P<0.05).The multivariate logistic regression analysis showed glucocorticoids treatment was the independent risk factor of CDI in UC patients(OR=4.111,95%CI:1.581-9.131,P=0.001).Conclusion Systemic treatment with glucocorticoids increases the risk of CDI in UC patients.

关 键 词：溃疡性结肠炎 艰难梭菌 临床特征 危险因素 

分 类 号：R574.62[医药卫生—消化系统]