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[目的]通过对类风湿关节炎(RA)患者医院感染病案的研究,提取与之相关的危险因子。[方法]对我院类风湿内科2008年6月—2010年9月收住入院的所有类风湿关节炎患者1 020例进行回顾性调查,统计分析患者的各项信息,包括姓名、性别、年龄、合并症、病程、活动指数、实验室检验指标、用药、医院感染情况。[结果]调查的1 020例RA患者,女性824例,男性196例,发生院内感染316例,感染率为30.98%,其中男性44例,女性272例,性别感染率分别为22.45%和33.01%。感染者中有34例存在多部位感染,32例出现2种感染,2例存在3种感染并见,感染例次共352例,例次感染发生率为34.5%。有399例合并有其他的疾病,其中139例发生院内感染,感染发生率占43.99%。本研究显示,患者的性别、血白细胞数、血红蛋白、超敏C反应蛋白、强的松的使用、合并症在感染组与非感染组比较均有统计学差异,P<0.05。合并症中糖尿病、慢性胆囊炎,骨质疏松、慢性阻塞性肺疾病在两组间有统计学差异,P<0.05。[结论]类风湿关节炎医院感染发生率高于国内外院内感染的平均水平。性别、血白细胞数、血红蛋白、超敏C反应蛋白、强的松的使用、合并症是类风湿关节炎患者发生医院感染的危险因子。而病程、免疫抑制剂的使用情况与发生院感不存在相关性。
[Objective] To study the risk factors of nosocomial infections in patients with rheumatoid arthritis (RA). [Methods] A total of 1 020 cases of rheumatoid arthritis admitted to our hospital from June 2008 to September 2010 were retrospectively analyzed. The information of patients were statistically analyzed, including name, sex, age , Complications, course of disease, activity index, laboratory test indicators, medication, hospital infection. [Results] Among the 1,020 RA patients surveyed, 824 were female and 196 were male, with 316 nosocomial infections and 30.98% infections, including 44 males and 272 females. The prevalence rates of infection were 22.45% and 33.01% respectively, . There were 34 cases of infection in multiple parts of infection, 32 cases of two kinds of infection, two cases of three kinds of infection and see, the total number of cases were 352 cases, the incidence of infection was 34.5%. There are 399 cases with other diseases, of which 139 cases of nosocomial infections, the incidence of infection accounted for 43.99%. This study showed that the gender, blood leukocyte count, hemoglobin, high-sensitivity C-reactive protein, prednisone use, comorbidities in the infected and non-infected groups were statistically significant, P <0.05. Complications of diabetes, chronic cholecystitis, osteoporosis, chronic obstructive pulmonary disease in the two groups were statistically significant, P <0.05. [Conclusion] The incidence of nosocomial infection in rheumatoid arthritis is higher than the average level of nosocomial infection in China and abroad. Gender, blood leukocyte count, hemoglobin, high-sensitivity C-reactive protein, prednisone, and comorbidities were risk factors for nosocomial infections in patients with rheumatoid arthritis. The course of disease, the use of immunosuppressive agents and the occurrence of nociception does not exist.