在患有全身性红斑狼的住院患者中,mycophenolate mofetil使用和随后感染之间的关联:一个嵌套的病例对照研究
Qingqing Guo1, Xueyi Zhang1, Siqin Sun1
1Department of Rheumatology and Immunology, China Pharmaceutical University Nanjing Drum Tower Hospital, 321 Zhongshan Road, Nanjing, 210008, China.
Rheumatology and therapy
|September 24, 2023
概括
菌酸莫菲蒂尔 (MMF) 增加了系统性红斑狼 (SLE) 患者的感染风险. 这种风险在长时间使用MMF,年龄较大,并发症和联合免疫抑制剂时更高.
科学领域:
- 类风湿病学 类风湿病学
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
背景情况:
- 系统性红斑狼 (SLE) 是一种自身免疫性疾病.
- 菌酸莫菲蒂尔 (MMF) 对SLE患者感染风险的影响尚不清楚.
- 这项研究调查了MMF和SLE感染之间的关联.
研究的目的:
- 评估MMF使用与SLE患者感染风险之间的关联.
- 确定影响货币货币基金对感染发展影响的因素.
主要方法:
- 一项基于住院的观察性研究,采用嵌套病例控制设计.
- 分析了3339名SLE患者 (1577例,1762例对照).
- 后勤回归评估了货币货币基金与感染风险的关联,诊断后的一年内.
主要成果:
- 货币货币基金显著增加了整体感染 (aOR 1.90) 和特定类型的风险:细菌性 (aOR 2.07),病毒性 (aOR 1.92) 和机会性 (aOR 2.13).
- 观察到细菌血症/败血症,尿路感染/肌炎和疹的风险增加.
- 风险因素包括年龄大于55岁,糖尿病,中枢神经系统参与,血小板狭窄,更高的MMF剂量/持续时间,以及与其他免疫抑制剂 (如CYC) 结合使用.
结论:
- 使用MMF与SLE患者的各种感染有关.
- 与长期使用MMF,年龄较大,并发症和同时接受免疫抑制治疗 (例如CYC) 相关的风险较高.
- 这些发现凸显了需要仔细监测SLE患者在MMF.
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