【摘要】 目的探讨类风湿关节炎(rheumatoid arthritis, RA)患者合并肺部感染的临床特点及危险因素。方法回顾性研究合并肺部感染RA住院患者52例和未合并感染RA住院患者200例临床资料,其中严重感染21例,分析RA合并肺部感染及肺部严重感染的临床特点及危险因素。结果 RA患者中合并肺部感染52例,痰培养送检阳性率为36.54%,检出25株病原菌,其中细菌10株,支原体3株,真菌12株;肺部感染相关危险因素分析提示年龄>60岁、病程≥10年、吸烟、慢性肺疾病、激素治疗为独立危险因素,抗风湿药物(DMARDs)治疗为保护因素。肺部严重感染相关危险因素分析提示病程≥10年、吸烟、慢性肺疾病、激素治疗、补体C4降低为独立危险因素,DMARDs治疗为保护因素。结论 RA患者肺部感染的致病菌主要是真菌和细菌,当RA患者病程≥10年、吸烟、合并慢性肺疾病、激素治疗、补体C4降低时应注意肺部严重感染风险,DMARDs治疗可以降低RA患者肺部感染的风险。更多还原

【Abstract】 Objective To investigate the clinical features and risk factors of pulmonary infection in patients with rheumatoid arthritis(RA). Methods The clinical data of 52 RA patients with pulmonary infection and 200 RA patients without pulmonary infectionwere retrospectively reviewed. Among them, 21 patients were severely infected. The clinical features and risk factors of RA complicated with pulmonary infection and severe pulmonary infection were analyzed. Results There were 52 cases of pulmonary infection in RA patients, the positive rate of sputum culture was 36.54%. Totally 25 strains of pathogens were detected, including 10 strains of bacteria, 3 strains of mycoplasma and 12 strains of fungi. The analysis of related factors of pulmonary infection indicated that the independent risk factors included age(>60 years), RA duration of(≥10 years), smoking, chronic lung disease, use of corticosteroids and the decrease of complement C4, while the use of DMARDs was a protective factor. The analysis of related factors of severe pulmonary infection indicated thatindependent risk factors included RA duration(≥10 years), smoking, chronic lung disease, use of corticosteroids, and decrease of complement C4, while the use of DMARDs was a protective factor. Conclusion The pathogens of pulmonary infection in RA patients were mainly fungi and bacteria. Risk factors for pulmonary infection should be considered when deciding treatment for RA patient. The use of DMARDs can reduce the risk of pulmonary infection in RA patients.更多还原