中国感染控制杂志2025，Vol.24Issue(4)：469-477,9.DOI:10.12138/j.issn.1671-9638.20257199
ANCA相关血管炎患者潜伏结核分枝杆菌感染情况及激活的危险因素
Status of latent tuberculosis infection with Mycobacterium tuberculosis and risk factors for its activation in patients with ANCA-associated vasculitis
摘要
Abstract
Objective To evaluate the status of latent tuberculosis infection(LTBI)with Mycobacterium tubercu-losis and the risk of LTBI activation after glucocorticoid therapy in patients with anti-neutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV).Methods Clinical data of AAV patients who visited Xiangya Hospital of Central South University from May 2018 to May 2023 were retrospectively analyzed.According to the results of in-terferon-γ release assay(IGRA),they were divided into a LTBI group and a non-LTBI group.The LTBI group was subdivided into an active TB group(ATB group)and a non-ATB group according to the presence of ATB.General conditions and biochemical indicator characteristics of the two groups were compared.The COX regression model was used to analyze the risk factors for LTBI activation in AAV patients.Results A total of 302 AAV patients were included in this study,with an age of 64.0(53.0,71.0)years old,169 male cases(55.96％),and an IGRA positive rate of 24.17％(n=73).The proportion of patients with renal insufficiency in the LTBI group was higher than that in the non-LTBI group(79.45％vs 60.70％),with statistically significant difference(P＜0.05).In the LTBI group,the age of patients was 62.0(53.5,72.0)years old,44 cases were male(60.27％),out of which 11 cases(15.07％)had ATB.In the non-LTBI group,4 male cases(1.75％)had ATB.In the LTBI group,there were statistically significant differences between the ATB group and the non-ATB group in terms of daily average glucocorticoid levels,age,renal dysfunction,neutrophils,and blood creatinine(all P＜0.05).COX univariate re-gression analysis showed that statistically significant differences existed among the groups in terms of daily average glucocorticoid levels,daily average glucocorticoid levels＞11.75 mg/day,age,age＞65 years old,and blood crea-tinine levels ≥150 μmol/L(all P＜0.05).COX multivariate regression analysis showed that daily average glucocor-ticoid levels＞11.75 mg/day(OR=0.14,95％CI:1.30-79.01)and age＞65 years(OR=0.08,95％CI:0.01-0.85)were independent influencing factors for LTBI activation.Conclusion AAV patients have a high rate of LT-BI,and daily average glucocorticoid levels＞11.75 mg/day is an independent risk factor for LTBI activation in AAV patients.Age＞65 years may benefit from receiving lower doses of immunosuppressive therapy,but it is necessary to expand sample size for further study.关键词
自身免疫性疾病/ANCA相关血管炎/潜伏结核/结核/危险因素/激活Key words
autoimmune disease/ANCA-associated vasculitis/latent tuberculosis/tuberculosis/risk factor/acti-vation分类
医药卫生引用本文复制引用
谢杨眉,钟永,陈金彪,张和平..ANCA相关血管炎患者潜伏结核分枝杆菌感染情况及激活的危险因素[J].中国感染控制杂志,2025,24(4):469-477,9.基金项目
湖南省卫生健康委科研计划课题(A202303050036) （A202303050036）
肾病医学发展科研基金(SMYY20220301001) （SMYY20220301001）
