摘要
目的分析类风湿性关节炎患者合并潜伏性结核感染的危险因素及调节性T淋巴细胞(Treg)和辅助性T淋巴细胞17(Th17)的预测价值.方法回顾性收集2021年1月-2022年8月石河子大学第一附属医院收治的119例类风湿性关节炎患者临床资料,根据患者是否合并潜伏性结核感染分为感染组32例和未感染组87例,单因素及多因素Logistic回归分析类风湿性关节炎患者合并潜伏性结核感染的危险因素,采用受试者工作特征(ROC)曲线分析Treg、Th17及Th17/Treg对类风湿性关节炎患者合并潜伏性结核感染的预测价值.结果119例类风湿性关节炎患者合并潜伏性结核感染32例,感染率为26.89%;侵入性操作、1年内激素使用日均剂量较大、骨密度T值较低均为类风湿性关节炎患者合并潜伏性结核感染的独立危险因素(P<0.05);感染组外周血Treg、Th17及Th17/Treg水平均高于未感染组(P<0.05);ROC曲线结果显示,Treg、Th17及Th17/Treg联合预测类风湿性关节炎患者合并潜伏性结核感染的临床价值较高,曲线下面积(AUC)为0.903、特异度和敏感度分别为80.46%和90.62%.结论类风湿性关节炎患者潜伏性结核感染发生率较高,其危险因素包括侵入性操作、1年内激素使用日均剂量较多、骨密度T值,Treg、Th17及Th17/Treg联合对类风湿性关节炎患者潜伏性结核感染具有较好的预测价值.
OBJECTIVE To analyze the risk factors for latent tuberculosis infection in the patients with rheumatoid arthritis and observe the predictive values of regulatory T lymphocyte(Treg)and helper T lymphocyte 17(Th17).METHODS The clinical data were retrospectively collected from 119 rheumatoid arthritis patients who were treated in the First Affiliated Hospital of Shihezi University from Jan 2021 to Aug 2022.The enrolled patients were divided into the infection group with 32 cases and the no infection group according to the status of complication with latent tuberculosis infection.Univariate analysis and multivariate logistic regression analysis were performed for the risk factors for the latent tuberculosis infection in the patients with rheumatoid arthritis.The values of Treg,Th17 and Th17/Treg in prediction of latent tuberculosis infection were analyzed by means of receiver operating characteristic(ROC)curves.RESULTS Among the 119 patients with rheumatoid arthritis,32 were complicated with latent tuberculosis infection,with the infection rate 26.89%.Invasive procedure,daily use of high dose of hormone within 1 year and low T value of bone mineral density were the independent risk factors for the latent tuberculosis infection in the patients with rheumatoid arthritis(P<0.05).The levels of peripheral blood Treg,Th17 and Th17/Treg of the infection group were higher than those of the no infection group(P<0.05).ROC curve analysis showed that the joint detection of Treg,Th17 and Th17/Treg had high clinical value in prediction of latent tuberculosis infection in the patients with rheumatoid arthritis,the area under curve(AUC)was O.903,with the sensitivity 80.46%,the specificity 90.62%,the sensitivity 90.62%.CONCLUSION The incidence of latent tuberculosis infection is high among the patients with rheumatoid arthritis.The risk factors include the invasive procedure,daily use of high dose of hormone within 1 year and T value of bone mineral density.The joint detection of Treg,Th17 and Th17/Treg has high value in prediction o
作者
余丽君
潘歆
詹爱琴
陈晨
魏亚州
YU Li-jun;PAN Xin;ZHAN Ai-qin;CHEN Chen;WEI Ya-zhou(The First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 832000,China)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2023年第17期2600-2604,共5页
Chinese Journal of Nosocomiology
基金
新疆维吾尔自治区科研基金资助项目(2021LJ03411)。
