类风湿性关节炎患者感染风险因素的临床研究

Clinical Study on Risk Factors of Infection in Patient with Rheumatoid Arthritis

观察类风湿性关节炎患者的各种感染性事件,分析与之相关的各种风险因素。方法:这是一个回顾性研究,调查和随访2003年6月—2008年6月5年间在我科接受治疗超过1年以上RA患者,统计其因感染性疾病而住院的事件,收集患者的各种信息,包括性别、年龄、病程、病期、药物、合并疾病等,汇总进行分析。结果:本次研究总共观察98例病人,结果在治疗期间有7例患过急性肺炎,2例患过急性尿路感染,2例患过软组织感染,1例患过化脓性关节炎,1例患过III型肺结核,1例患过PCP肺炎,肺部感染总数9例,与其他部位感染人数比较均P<0.05,差异有显著性;治疗3年以上患者的感染率与治疗3年以下的感染率比较P<0.05,差异有显著性;感染组患者的强地松和甲氨喋呤的服用剂量与未感染组比较,P均<0.05,差异有显著性,此外感染组的年龄、病程与未感染组比较P均<0.05,差异有显著性。结论:①研究表明在治疗RA的长期过程中,遭受肺部感染的风险最高。②RA患者感染风险与强地松和甲氨喋呤的服用剂量和持续时间以及患者的年龄和病程成正相关关系。

Objectlve：Observe the infection events in patient with rheumatoid arthritis（RA）, and analyse its relative risk factors. Methods： This observation is a lengthways retrospective study, visit patient who has accepted the treatment above one year from June 2003,to June 2008, and investigate the hospitalization events due to the infection, collect patient＇s messages include gender, age, duration, stage, medication, complication, etc. handling the statistics with SPSS for Windows 13.0. Result： in this study we have investigated 98 patients, in during of the treatment, 7 of them were suffered from acute pneumonia, 2 of them were suffered from acute urinary tract infection, 2 of them were suffered from soft tissue＇s infection, one of them has suffered from tuberculosis, and other one has suffered from pneumocystis carinii pneumonia（PCP）, Total Pulmonary infection is 9 cases, which comparing with other place infection were significandy increased, P〈0.05. The infection rate of patient who has taking drugs over 3 years comparing with patient who has taking drugs below 3 years was significantly higher, P〈0.05. the dosage of steroid and MTX of infection group comparing with non-infection group were significantly higher, P〈0.05, furthermore, age and stage of the infection group comparing with non-infection＇s were significantly higher, P〈0.05. Conclusion： （1）This study indicate that in the long term therapy for RA, patients who easily suffer from pulmonary infection.（2）Theinfection risk of patient with RA correlate with dosage and duration of steroid and MTX, and also correlate with age and stage of patient with RA.