在接受生物疾病修饰性抗风湿药物的类风湿性关节炎患者中潜伏和活跃结核病的发展:单中心前性研究
Binh Bui Hai1, Tuan Le Anh2, Phuong Nguyen Thi Thu3,4
1Centre of Rheumatology, Bach Mai Hospital, Hanoi, Vietnam.
PloS one
|January 11, 2024
概括
对于类风湿性关节炎 (RA) 的生物药物可以重新激活结核病 (TB). 在越南,20%的RA患者患有潜伏结核病,1.7%患有活跃结核病. 早期查和监测对于开始生物治疗的RA患者至关重要.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 生物疗法已经改变了类风湿性关节炎 (RA) 治疗.
- 在患有潜伏性结核病感染的患者中,生物药物携带结核病 (TB) 再激活的风险.
- 强制性结核病查对于RA患者在开始生物治疗之前至关重要.
研究的目的:
- 分析在越南巴赫迈医院 (2017-2022) 接受生物DMARD的RA患者的临床特征.
- 确定与这些患者活跃和潜伏结核病感染相关的因素.
- 在高结核病负担的环境中为RA患者提供结核病查,监测和治疗策略的信息.
主要方法:
- 对180名接受生物治疗的RA患者进行前性研究.
- 12个月的随访期.
- 对临床特征和结核病感染发生率的分析.
主要成果:
- 20%的患者患有潜伏的结核病感染;1.7%的患者患有活跃的结核病 (肺,,脏).
- 结核病暴露史和较低的教育水平与较高的结核病发病率有关 (ORs 1.98和1.45).
- 随访持续时间和诊断测试 (X射线,CT,支气管检查,唾液AFB) 有助于早期的潜在结核病诊断.
结论:
- 潜在的结核病感染在像越南这样的高结核病负担的国家的RA患者中非常普遍.
- 结核病的危险因素包括先前接触和有限的教育.
- 加强诊断监测对于早期检测和治疗RA患者的结核病至关重要.
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