强直性脊柱炎的感染因素调查

Infections in Ankylosing Spondylitis Patients:A Clinical Investigation

目的研究强直性脊柱炎(AS)与感染的关系。方法横断面研究188例住院AS患者的呼吸道、泌尿生殖和胃肠道等感染状况,分析其与血红细胞沉降率(ESR)、C反应蛋白(CRP)和疾病活动的关系,统计方法采用χ2检验。结果 AS总体临床感染率为59.6%,有呼吸道感染比例为39.9%,已婚者和未婚者泌尿生殖道感染为24.2%和12.5%,胃肠道感染为9.0%;其中总体感染和呼吸道感染与CRP升高的患者例数(χ2分别为5.7和4.26,P分别为0.017和0.039)、活动期例数(χ2分别为5.96和13.4,P分别为0.015和0.0003)密切相关,呼吸道感染还与血沉升高有关(χ2=4.24,P=0.04);胃肠道和泌尿生殖道感染与血沉、CRP和疾病活动例数无关。结论呼吸道感染是导致AS疾病活动的危险因素之一,但泌尿生殖系统感染和胃肠道感染与疾病活动无关。

OBJECTIVE To investigate the relationship between infections in upper respiratory tract（URT）,enteric and genitourinary tract and ankylosing spondylitis（AS）.METHODS A cross sectional study was used to investigate infections in URT,enteric and genitourinary tract among 188 non-selected AS inpatients and their associations with erythrocyte sedimentation rate（ESR）,serum C reactive protein（CRP） and disease activities.RESULTS The overall prevalence of infections was 59.6%,with 39.9% of infections occurring in URT,9.0% in enteric and 20.2% in genitourinary tract.In AS patients with infections,more had elevated CRP（76.8% vs 60.5%,χ2=5.7,P=0.017） and active disease（58.9% vs 40.8%,χ2=5.96,P=0.015）,compared those with negative infections.Compared with patients with negative URT infections,URT infection accounted for more with elevated ESR（70% vs 55.8%,χ2=4.24,P=0.04）,elevated CRP（78.7% vs 64.6%,χ2=4.26,P=0.039） and active disease（68% vs 40.7%,χ2=4.74,P=0.0003） in patient with URT infections,while the enteric and genitourinary tract infection hadn＇t any associations with elevated ESR,CRP or active disease.CONCLUSION URT infection is a high risk factor for active ankylosing spondylitis whereas the enteric and genitourinary tract infection is not.