克罗恩病合并机会性感染的现状及影响因素分析
收稿日期: 2025-01-23
网络出版日期: 2026-01-30
版权
Analysis of current status and influencing factors of opportunistic infections in Crohn disease
Received date: 2025-01-23
Online published: 2026-01-30
Copyright
目的：探究克罗恩病合并机会性感染的现状及其影响因素。 方法：回顾性收集2020年1月至2024年8月上海某三甲医院收治的369例克罗恩病患者的人口学特征、疾病特征、治疗方案及实验室检查结果。采用单因素分析和多因素Logistic回归分析克罗恩病合并机会性感染的影响因素。 结果：克罗恩病患者机会性感染发生率为32.25%，其中病毒感染、细菌感染及多重感染的发生率分别为16%、12.2%、3.8%。多因素Logistic回归分析显示，疾病轻度活动[优势比（odds ratio，OR） =3.22, 95% CI: 1.18～8.81, P=0.023]、疾病中度活动（OR=7.16, 95% CI: 1.88～27.31, P=0.004）、白蛋白<30 g/L（OR=4.99, 95% CI: 2.04～12.18, P<0.001）、C反应蛋白>10 mg/L（OR=3.70, 95% CI: 1.27～10.78, P=0.016）为克罗恩病合并EB病毒感染的独立危险因素。Charlson合并症指数评分为1分（OR=5.01, 95% CI: 1.51～16.60, P=0.008）、白蛋白<30 g/L（OR=3.45, 95% CI: 1.23～9.72, P=0.019）、C反应蛋白>10 mg/L（OR=13.06, 95% CI: 2.46～69.40, P=0.003）为克罗恩病合并潜伏结核分枝杆菌感染的独立危险因素。C反应蛋白>10 mg/L（OR=20.41, 95% CI: 2.13～195.52, P=0.009）为克罗恩病合并多重感染的独立危险因素。结论：疾病活动度、合并慢性病、低白蛋白血症及C反应蛋白升高为克罗恩病患者发生机会性感染的预测因素，对此类患者应进行积极预防与早期诊治。
蔡晖 , 李幼生 , 黄雨桦 , 许菁菁 , 刘庆芬 , 顾芬 . 克罗恩病合并机会性感染的现状及影响因素分析[J]. 内科理论与实践, 2026 , 20(06) : 440 -448 . DOI: 10.16138/j.1673-6087.2025.06.03
Objective To explore the current status and influencing factors of opportunistic infections in Crohn disease. Methods Data on demographic characteristics, disease features, treatment regimens and laboratory results of 369 patients with Crohn disease admitted to a tertiary grade A hospital in Shanghai from January 2020 to August 2024 were retrospectively collected. Univariate analysis and multivariate Logistic regression were employed to identify the influencing factors of opportunistic infections in Crohn disease. Results The incidence of opportunistic infections in patients with Crohn disease was 32.25%. Specifically, the incidence rates of viral infections, bacterial infections, and multiple infections were 16%, 12.2%, and 3.8%, respectively. Multivariate Logistic regression analysis showed that low disease activity [odds ratio (OR)=3.22, 95% CI: 1.18−8.81, P=0.023], moderate disease activity (OR=7.16, 95% CI: 1.88−27.31, P=0.004), albumin < 30 g/L (OR=4.99, 95% CI: 2.04−12.18, P < 0.001), and C-reactive protein > 10 mg/L (OR=3.70, 95% CI: 1.27−10.78, P=0.016) were independent risk factors for Crohn disease complicated with Epstein-Barr virus infection. A Charlson comorbidity index score of 1 (OR=5.01, 95% CI: 1.51−16.60, P=0.008), albumin < 30 g/L (OR=3.45, 95% CI: 1.23−9.72, P=0.019), and C-reactive protein >10 mg/L (OR=13.06, 95% CI: 2.46−69.40, P=0.003) were independent risk factors for Crohn disease complicated with latent mycobacterium tuberculosis infection. C-reactive protein >10 mg/L (OR=20.41, 95% CI: 2.13−195.52, P=0.009) was an independent risk factor for Crohn disease complicated with multiple infections. Conclusions Disease activity, co-existing chronic diseases, hypoalbuminemia, and elevated C-reactive protein levels are predictive factors for opportunistic infections in patients with Crohn disease. Active prevention as well as early diagnosis and treatment should be implemented for these patients at risk.
Key words： Crohn disease; Opportunistic infection; Influencing factors
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