溃疡性结肠炎患者中机会性感染的临床特点分析87例

Clinical features of opportunistic infections in ulcerative colitis patients

目的:探讨溃疡性结肠炎(ulcerative colitis,UC)患者中机会性感染的临床特点及巨细胞病毒(cytomegaoviyns,CMV)感染的相关危险因素.方法:选取南京医科大学附属南京医院(南京市第一医院)2004-03/2015-04收治的87例U C患者为研究对象,对其临床特征、内镜表现、病理学特征以及实验室检查进行总结分析,根据患者是否合并CMV感染将其分为阳性组和阴性组,并对其危险因素进行总结分析.结果:87例UC患者中,CMV阳性12例,艰难梭状芽孢杆菌5例,口腔念珠菌感染3例,卡氏肺孢子虫感染2例.患者病程中白细胞减低、全结肠炎、近2 mo使用激素、非甾体类抗炎药(non-steroidal anti-inflammatory drugs,NSAIDS)、抗生素是CMV的独立危险因素,CMV阳性的患者中近2 mo使用质子泵抑制剂(proton pump inhibitor,PPI)的比率大于CMV阴性组,但差异没有统计学意义.结论:UC患者中容易并发CMV、艰难梭状芽孢杆菌、口腔念珠菌病、卡氏肺孢子虫等机会性感染.UC病程中出现白细胞减低、全结肠炎、近2 mo使用激素、NSAIDs、抗生素是CMV感染的独立危险因素.

AIM： To explore the clinical features of opportunistic infections and the underlying risk factors of cytomegalovirus （CMV） infection in ulcerative colitis （UC） patients. METHODS： We enrolled 87 ulcerative colitis patients treated at our hospital from March 2004 to April 2015. Data concerning clinical manifestations, endoscopic characteristics, pathological changes as well as laboratory findings were collected and analyzed. We further divided the patients into a CMV positive and a CMV negative group to explore the possible risk factors for CMV infection. RESULTS： Among 87 patients, there were 12 CMV positive patients, 5 Clostridium difficile positive patients, three oral Candida positive patients, and two Pneumocystis carinii positive patients. Independent risk factors for CMV infection in UC patients included low leukocyte count, pan-colitis, and use of corticosteroids, non-steroidal anti-inflammatory drugs （NSAIDs） as well as antibiotics during recent 2 too, while the use of proton pump inhibitors （PPIs） had no significant impact on CMV infection. CONCLUSION： UC patients tend to develop opportunistic infections, such as CMV, Clostridiumdifficile, oral Candida and Pneumocystis carinii infections. Low leukocyte count, pan-colitis, use of corticosteroids, NSAIDs as well as antibiotics during recent 2 mo are risk factors for CMV infection in UC patients.