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贝赫切特病患者活动性结核病的临床特征和危险因素。

Clinical Features and Risk Factors of Active Tuberculosis in Patients with Behçet's Disease.

机构信息

Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China.

Peking Union Medical College Hospital, Chinese Academy of Medical Science, Clinical Epidemiology Unit, International Epidemiology Network, Beijing 100730, China.

出版信息

J Immunol Res. 2020 Nov 24;2020:2528676. doi: 10.1155/2020/2528676. eCollection 2020.

Abstract

To investigate the clinical features and potential risk factors of active tuberculosis (ATB) in Behçet's disease (BD), we conducted a case-control study on hospitalized BD patients in our institute from 2010 to 2019. BD patients with ATB were enrolled as the case group. The control group was selected by random number sampling from the remaining BD patients, including those with latent tuberculosis infection, previous tuberculosis, or without tuberculosis. Finally, we reviewed 386 BD patients and identified 21 (5.4%) ATB cases, including four (19.0%) microbiologically confirmed and 17 (81.0%) clinically diagnosed. We found that BD patients with ATB were more prone to have systemic symptoms (fever, night sweating, and unexplained weight loss) and/or symptoms related to the infection site. Multivariate logistic regression analysis revealed that erythrocyte sedimentation rate (ESR) > 60 mm/h (OR = 13.710, 95% CI (1.101, 170.702)), increased IgG (OR = 1.226, 95% CI (1.001, 1.502)), and positive T-SPOT.TB (OR = 7.793, 95% CI (1.312, 48.464), for 24-200 SFC/10PBMC; OR = 17.705 95% CI (2.503, 125.260), for >200 SFC/10PBMC) were potential risk factors for ATB in BD patients. Our study suggested that when BD patients have systemic symptoms with significantly elevated TB-SPOT, the diagnosis of ATB should be considered.

摘要

为了研究 Behçet 病(BD)患者中活动性结核病(ATB)的临床特征和潜在危险因素,我们对 2010 年至 2019 年我院住院的 BD 患者进行了病例对照研究。将 ATB 患者纳入病例组。对照组通过随机数字抽样从其余 BD 患者中选择,包括潜伏性结核感染、既往结核病或无结核病患者。最终,我们回顾了 386 例 BD 患者,发现 21 例(5.4%)ATB 病例,包括 4 例(19.0%)微生物学确诊和 17 例(81.0%)临床诊断。我们发现,ATB 的 BD 患者更易出现全身症状(发热、盗汗和不明原因体重减轻)和/或与感染部位相关的症状。多变量 logistic 回归分析显示,红细胞沉降率(ESR)>60mm/h(OR=13.710,95%CI(1.101,170.702))、升高的 IgG(OR=1.226,95%CI(1.001,1.502))和阳性 T-SPOT.TB(OR=7.793,95%CI(1.312,48.464),对于 24-200 SFC/10PBMC;OR=17.705,95%CI(2.503,125.260),对于>200 SFC/10PBMC)是 BD 患者 ATB 的潜在危险因素。我们的研究表明,当 BD 患者出现全身症状且 TB-SPOT 显著升高时,应考虑 ATB 的诊断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9d4f/7707958/ae200aac1502/JIR2020-2528676.001.jpg

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