贵州地区类风湿关节炎患者合并结核感染的危险因素分析  

Risk factors analysis of rheumatoid arthritis combined with tuberculosis infection in Guizhou region

作　　者：李珣 李星一 刘俊 李培霆 李龙 LI Xun;LI Xingyi;LIU Jun;LI Peiting;LI Long(Department of Rheumatology and Immunology,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China;School of Clinical Medicine,Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院风湿免疫科,贵州贵阳550004 [2]贵州医科大学临床医学院,贵州贵阳550004

出　　处：《贵州医科大学学报》2024年第4期609-614,共6页Journal of Guizhou Medical University

基　　金：贵州省卫健委科学技术基金项目(gzwk[j2021-141]、gzwk[j2021-147]、gzwk[j2022-325]);贵州省科技计划项目(黔科合基础-ZK[2023]一般397)。

摘　　要：目的探讨贵州地区类风湿关节炎(RA)患者合并结核(TB)感染的危险因素。方法选取RA患者103例作为研究对象,根据合并TB感染情况分为单纯RA组(n=71)和RA合并TB组(n=32);比较2组患者的一般资料、RA疾病程度、既往药物使用情况、实验室及其他检查指标等;将具有统计学差异的指标进行多因素logistic回归分析筛选RA合并TB感染的危险因素。结果与单纯RA组比较,RA合并TB组患者血细胞沉降率(ESR)和C反应蛋白(CRP)升高(P<0.05),使用肿瘤坏死因子抑制剂(TNFi)和既往TB感染史等方面比较差异具有统计学意义(P<0.05);二元logistic回归分析后提示CRP和ESR的升高、TNFi的使用及既往TB感染史为RA合并TB感染的危险因素(P<0.05)。结论CRP和ESR的升高、TNFi的使用及既往TB感染史是贵州地区RA合并TB感染的危险因素。Objective To investigate risk factors of rheumatoid arthritis(RA)complicated with tuberculosis(TB)infection in Guizhou region.Methods A total of 103 patients with RA were selected as research subjects.According to TB infection status,the patients were divided into simple RA group(n=71)and RA combined with TB group(n=32).General information,degree of RA disease,past medication use and other laboratory test results were compared between two groups.Multivariate logistic regression analysis was performed on above factors with statistically differentiated differences to identify risk factors for RA combined with TB infection.Results When compared with simple RA group,RA combined with TB group showed the increases in erythrocyte sedimentation rate(ESR)and C-reactive protein(CRP,P<0.05),and there were statistically significant differences in the use of tumor necrosis factor inhibitor(TNFi)and a history of TB infection(P<0.05).Binary logistic regression analysis suggested that elevated CRP and ESR,use of TNFi and previous history of TB infection were independent risk factors for TB infection in RA patients.Conclusion Elevated CRP and ESR,use of TNFi and previous history of TB infection are risk factors for RA combined with TB infection in Guizhou region.

关 键 词：类风湿关节炎 结核感染 危险因素 既往感染 肿瘤坏死因子抑制剂 糖皮质激素 

分 类 号：R593.22[医药卫生—内科学]