摘要
目的分析类风湿性关节炎(RA)并发结核感染的危险因素,并构建预测模型。方法选取2019年4月-2020年12月医院收治的RA患者187例,采用结核分枝杆菌感染T淋巴细胞斑点试验检测结核感染情况,并分析感染者临床特征,依据是否发生结核感染分为感染组、未感染组,对比两组临床资料,分析影响RA患者并发结核感染的危险因素。结果187例RA患者中52例发生结核感染,感染率27.81%(52/187),患者以发热、咳嗽、体质量降低为主要表现,其中45例为结核潜伏感染,5例为非活动性结核病,2例为活动性结核病;感染部位以肺结核为主(73.08%),肺外结核中以关节结核占比较多(13.46%),38例肺结核者中33例肺受累,CT显示11例病灶位于典型肺结核发生部位;既往结核病感染史、侵入性操作、sCD14-ST、抗CCP抗体、抗MCV抗体为RA患者并发结核感染的危险因素(P<0.05),骨密度T值为保护因素(P<0.05),据此建立预测模型Z=0.268×既往结核病感染史+0.233×侵入性操作+0.368×(sCD14-ST)+0.399×抗CCP抗体+0.507×抗MCV抗体-0.389×骨密度T值-26.887。结论RA患者并发结核感染率高,以结核潜伏感染为主,多为肺结核,且其影响因素较多,需据此展开干预措施。
OBJECTIVE To analyze the risk factors for rheumatoid arthritis(RA)complicated with tuberculosis infection,and construct a prediction model.METHODS A total of 187 patients with RA admitted to the hospital from Apr 2019 to Dec 2020 were recruited.The status of tuberculosis infection was determined by T-lymphocyte spot test(T-SPOT),and clinical characteristics of the infected patients were analyzed.According to whether tuberculosis infection occurred,the patients were divided into the infected group and uninfected group.Clinical data of the two groups were compared and the risk factors for RA complicated with tuberculosis infection were analyzed.RESULTS Fifty-two in the 187 patients occurred tuberculosis infection,with an infection rate of 27.81%(52/187).Fever,cough,and weight loss were main symptoms.There were 45 patients with latent tuberculosis infection,5 patients with inactive tuberculosis,and 2 patients with active tuberculosis.The proportions of pulmonary tuberculosis(73.08%)and joint tuberculosis(13.46%)were higher.Thirty-three of the 38 cases had pulmonary involvement and CT showed that lesions of 11 patients were located in typical incidence sites of pulmonary tuberculosis.Previous history of tuberculosis,invasive procedures,sCD14-ST,anti-CCP antibody,and anti-MCV antibody were risk factors for tuberculosis in patients with RA(P<0.05),while bone mineral density T-score was a protective factor(P<0.05).The prediction model constructed based on these factors was as follows:Z=0.268×previous history of tuberculosis+0.233×invasive procedures+0.368×(sCD14-ST)+0.399×anti-CCP antibody+0.507×anti-MCV antibody-0.389×bone mineral density T-score-26.887.CONCLUSION The incidence of tuberculosis is high in patients with RA,mainly tuberculosis latent infection,mostly tuberculosis,and its influencing factors are many,so intervention measures should be carried out accordingly.
作者
任占芬
罗寰
杨金良
赵悦
左路广
REN Zhan-fen;LUO Huan;YANG Jin-liang;ZHAO Yue;ZUO Lu-guang(The First Affiliated Hospital of Hebei North University,Zhangjiakou,Hebei 07500,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第23期3576-3580,共5页
Chinese Journal of Nosocomiology
基金
河北省卫健委基金资助项目(20200512)。
关键词
类风湿性关节炎
结核感染
危险因素
预测模型
Rheumatoid arthritis
Tuberculosis infection
Risk factor
Prediction model
