类风湿关节炎患者院内感染影响因子调查分析

Analysis on impact factors for nosocomial infection in patients with rheumatoid arthritis

[目的]通过对类风湿关节炎(RA)患者医院感染病案的研究,提取与之相关的危险因子。[方法]对我院类风湿内科2008年6月—2010年9月收住入院的所有类风湿关节炎患者1 020例进行回顾性调查,统计分析患者的各项信息,包括姓名、性别、年龄、合并症、病程、活动指数、实验室检验指标、用药、医院感染情况。[结果]调查的1 020例RA患者,女性824例,男性196例,发生院内感染316例,感染率为30.98%,其中男性44例,女性272例,性别感染率分别为22.45%和33.01%。感染者中有34例存在多部位感染,32例出现2种感染,2例存在3种感染并见,感染例次共352例,例次感染发生率为34.5%。有399例合并有其他的疾病,其中139例发生院内感染,感染发生率占43.99%。本研究显示,患者的性别、血白细胞数、血红蛋白、超敏C反应蛋白、强的松的使用、合并症在感染组与非感染组比较均有统计学差异,P<0.05。合并症中糖尿病、慢性胆囊炎,骨质疏松、慢性阻塞性肺疾病在两组间有统计学差异,P<0.05。[结论]类风湿关节炎医院感染发生率高于国内外院内感染的平均水平。性别、血白细胞数、血红蛋白、超敏C反应蛋白、强的松的使用、合并症是类风湿关节炎患者发生医院感染的危险因子。而病程、免疫抑制剂的使用情况与发生院感不存在相关性。

[Objective] To investigate the nosocomial infection risk factors on rheumatoid arthritis.[Methods] This observation was a lengthways retrospective study,focusing in the inpatients in Guanghua hospital from June 2008 to September 2010;their messages and data were studied including gender,age,duration,medication,and infection status.[Results] A total of 1020 patients were investigated,of whom 824 were female and 196 male,their age being 17-92 years old and the average age 48 years old,with 316 cases developing nosocomial infection.The infection rate was 30.98%.Thirty four cases were multi-site infections,and 32 cases had two kinds of infection,2 cases had three kinds of infection.The comparations between infection and non-infection groups in peripheral blood leukocytes count,plasma hemoglobin,C-reactive protein,gender,the dose of steroid and accompany diseases were significantly different（P0.05）.[Conclusion] Multi-factor regression analysis showed that peripheral blood leukocytes count,plasma hemoglobin,C-reactive protein,gender,the dose of steroid and accompanied diseases were the risk factors for nosocomial infection in RA.The nosocomial infection rate in RA was much higher than average nosocomial infection rate both at home and abroad.