【摘要】 背景：溃疡性结肠炎（UC）患者发生机会性感染的风险较健康人群显著增高，且对预后有不良影响。目的：分析UC患者的肠道机会性感染发生情况，以及合并机会性感染的危险因素。方法：回顾性收集2012年1月—2020年12月在北京大学第三医院住院治疗的UC病例，采集人口统计学、临床、实验室、内镜、病理和用药信息，采用单因素和多因素分析筛选合并肠道机会性感染的影响因素。结果：共275例UC患者纳入研究，肠道机会性感染检出率为26.2%，其中巨细胞病毒（CMV）、EB病毒（EBV）、真菌、艰难梭菌、阿米巴和多重感染率分别为13.5%、14.5%、5.1%、1.5%、1.1%和9.1%。多因素Logistic回归分析显示，疾病重度活动（OR=6.517, 95%CI:1.487～28.552, P=0.013）、白蛋白<30 g/L(OR=3.895, 95%CI:1.590～9.544, P=0.003)是合并CMV感染的独立危险因素。合并EBV感染的独立危险因素包括疾病重度活动（OR=11.260, 95%CI:2.249～56.382, P=0.003）、白蛋白<30 g/L(OR=2.548, 95%CI:1.096～5.927, P=0.030)和C反应蛋白（CRP）升高（OR=1.046, 95%CI:1.007～1.086, P=0.019）。对于UC合并真菌感染，慢性复发型患者发生风险较低（OR=0.278, 95%CI:0.087～0.886, P=0.030）。肠道多重感染主要由病毒感染构成，独立危险因素与肠道CMV、EBV感染相似。结论：UC合并肠道机会性感染以病毒感染为主。疾病活动度、炎症反应程度和白蛋白降低是UC合并肠道病毒感染的危险因素，而真菌感染风险仅与临床分型有关。更多还原

【Abstract】 Background: subjects, and has adverse impact on clinical outcome. Aims: To analyze the prevalence of opportunistic intestinal infection in UC patients and explore the risk factors of UC complicated with opportunistic infection. Methods: Clinical data of patients with UC hospitalized in Peking University Third Hospital from January 2012 to December 2020 were collected retrospectively. Information on demography, clinical characteristics, laboratory, endoscopic and pathological findings, as well as the medication histories were recorded; the factors associated with opportunistic intestinal infection were analyzed using univariate and multivariate analyses. Results: A total of 275 UC patients were included, with an opportunistic intestinal infection rate of 26.2%; among which, rates of cytomegalovirus(CMV), Epstein-Barr virus(EBV), fungi,Clostridium difficile, amoeba, and multiple infection were 13.5%, 14.5%, 5.1%, 1.5%, 1.1%, and 9.1%, respectively.Multivariate Logistic analysis demonstrated that severe disease activity(OR=6.517, 95% CI: 1.487-28.552, P=0.013) and albumin <30 g/L(OR=3.895, 95% CI: 1.590-9.544, P=0.003) were independent risk factors for CMV infection. The independent risk factors for EBV infection included severe disease activity(OR=11.260, 95% CI: 2.249-56.382, P=0.003),albumin <30 g/L(OR=2.548, 95% CI: 1.096-5.927, P=0.030) and C-reactive protein(CRP) elevation(OR=1.046, 95% CI:1.007-1.086, P=0.019). While for intestinal fungal infection, the risk in patients with chronic relapsing type UC was lower(OR=0.278, 95% CI: 0.087-0.886, P=0.030). Intestinal multiple infection was mainly composed of viral infection, and the independent risk factors were similar to those of CMV and EBV infection. Conclusions: Most of the opportunistic intestinal infection in UC patients is viral infection. Disease activity, inflammatory response and reduced albumin are risk factors for intestinal viral infection in UC patients, while the risk of fungal infection is only related to clinical subtyping.更多还原