患有潜伏结核病的类风湿患者发展为活跃结核病的危险因素:一项回顾性研究
Fengjuan Wang1, Lei Zhou1, Xiaoyan Hao1
1Department of Clinical Laboratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China.
Immunity, inflammation and disease
|October 15, 2025
概括
风湿病患者面临着潜伏结核病感染 (LTBI) 进展为活性结核病 (ATB) 的高风险. 高剂量葡萄糖皮质体治疗 (≥20mg/天) 是这些人LTBI激活的重要危险因素.
科学领域:
- 免疫学和传染病的研究
- 类风湿病学 类风湿病学
- 公共卫生 公共卫生
背景情况:
- 风湿性疾病 (RD) 涉及对身体的自身免疫性攻击,增加对结核病等感染的易感性.
- 患有RD的患者免疫力受损,因此他们容易患有潜伏性结核病感染 (LTBI) 引起的活跃结核病 (ATB).
研究的目的:
- 在被诊断患有风湿性疾病 (RD) 的患者中,研究潜伏性结核感染 (LTBI) 进展为活跃结核 (ATB) 的风险因素.
主要方法:
- 一项回顾性研究分析了2012年1月至2022年10月在西京医院的32235名RD患者的数据.
- 评估了LTBI查率和发病率,重点关注LTBI患者ATB发展的风险因素.
主要成果:
- 在RD患者中,LTBI的发病率为25.33%,只有18.60%的患者接受了查.
- 葡萄糖皮质激素 (GC) 治疗,特别是每天≥20mg的剂量,被确定为LTBI激活的独立风险因素 (OR=3.59).
- 系统性红斑狼 (SLE) 和类风湿性关节炎 (RA) 在LTBI患者中很常见,其中56.44%接受GC治疗.
结论:
- 在中国的RD患者中,LTBI的患病率很高,因此在开始高剂量葡萄糖皮质体治疗 (≥20mg/天) 之前需要进行例行查.
- 密切监测和增强的诊断和治疗策略对于持续接受GC治疗的SLE和RA患者至关重要,以防止ATB.
- 在RD患者中主动管理LTBI至关重要,以减轻进展到活性结核病的风险.
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