克罗恩病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 the Clostridium difficile infection in Crohn's disease

作　　者：黄佳卉[1,4] 刘涛 Huang Jiahui;Liu Tao(Department of Clinical Laboratory,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Department of Gastroenterology,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510655,China;Biomedical Innovation Center,the Sixth Affiliated Hospital,Sun Yat-sen University,Guangzhou 510000,China)

机构地区：[1]中山大学附属第六医院临床检验科,广州510655 [2]中山大学附属第六医院消化内科,广州510655 [3]广东省结直肠盆底疾病研究重点实验室,广州510655 [4]广州市黄埔区中六生物医学创新研究院,广州510000

出　　处：《中华炎性肠病杂志（中英文）》2024年第5期384-389,共6页Chinese Journal of Inflammatory Bowel Diseases

摘　　要：目的分析克罗恩病(CD)合并艰难梭菌感染(CDI)患者的临床特征及危险因素。方法回顾性纳入中山大学附属第六医院消化内科2020年11月至2024年2月所有至少接受1次粪便产毒素艰难梭菌核酸检测的CD住院患者,采用试剂盒PCR法检测艰难梭菌感染情况。根据艰难梭菌检测结果,将患者分为阳性组和阴性组,比较两组患者的临床特征以及感染的独立危险因素。结果纳入1670例CD患者,男性1212例(72.6%),女性458例(27.4%)。阳性组344例(20.6%),阴性组1326例(79.4%)。艰难梭菌感染率为20.6%(344/1670)。阳性组与阴性组在性别、年龄、病程、腹泻、血清白蛋白、疾病行为及抗生素使用史差异均有统计学意义(P均<0.05)。二元logistic回归分析显示,抗肿瘤坏死因子-α单克隆抗体(OR=1.479,95%CI:1.085~2.015,P=0.013)、抗生素(OR=1.655,95%CI:1.164~2.355,P=0.005)、穿透型病变(OR=1.361,95%CI:1.019~1.818,P=0.037)是CD患者发生艰难梭菌感染的独立危险因素。结论CD患者有较高的CDI发生率,穿透型病变、近期使用过抗肿瘤坏死因子-α单克隆抗体和抗生素是CD患者发生CDI的独立危险因素。Objective To analyze the clinical characteristics and risk factors associated with Clostridium difficile infection(CDI)in patients with Crohn's disease(CD).Methods A retrospective investigation was conducted on all the CD patients who were tested for C.difficile at the Department of Gastroenterology,the Sixth Affiliated Hospital of Sun Yat-sen University from November 2020 to February 2024 using PCR for detection.Based on the results of C.difficile detection,patients were categorized into positive group and negative group,and their clinical features,and independent risk factors were analyzed and compared.Results A total of 1670 patients diagnosed with CD were included,involving 1212 males(72.6%)and 458 females(27.4%).Three hundred and forty-four patients(20.6%)were set as positive group,and 1326(79.4%)patients were set as negative group.The prevalence of C.difficile was found to be 20.60%(344/1670).Significant differences in gender,age,disease duration,diarrhea status,serum albumin levels,disease behaviors,and history of antibiotic use were observed between the positive group and negative group(P all<0.05).Binary logistic regression analysis revealed that tumor necrosis factor(TNF)-αinhibitors(OR=1.479,95%CI:1.085-2.015,P=0.013),antibiotics(OR=1.655,95%CI:1.164-2.355,P=0.005),as well as penetrating lesions(OR=1.361,95%CI:1.019-1.818,P=0.037)were independent risk factors for CDI in CD patients.Conclusion Patients with CD had a higher incidence of CDI,and penetrating lesions,recent use of TNF-αinhibitors and antibiotics were independent risk factors for CDI in patients with CD.

关 键 词：克罗恩病 艰难梭菌 感染 临床特征 危险因素 

分 类 号：R574[医药卫生—消化系统]