慢性肾脏病患者结核分枝杆菌感染流行情况及相关因素分析

朱倩莹; 程耀; 唐建; 吴桂辉

doi:10.7619/jcmp.20201820

慢性肾脏病患者结核分枝杆菌感染流行情况及相关因素分析

Prevalence of Mycobacterium tuberculosis infection in patients with chronic kidney disease and its related factors analysis

摘要

摘要:
目的分析慢性肾脏病（CKD）患者结核分枝杆菌感染流行情况及其相关因素。
方法选择327例CKD患者作为研究对象，收集CKD患者发生结核分枝杆菌感染的可能影响因素，根据有无合并结核分枝杆菌感染将患者分为2组，比较2组上述各因素差异，并采用多因素Logistic回归分析判断各因素的综合作用。
结果 327例CKD患者中，63例（19.27%）患者被检出结核分枝杆菌感染；多因素Logistic回归分析结果显示，女性（OR=0.710，95% CI为0.526~0.959）、血浆白蛋白≥35 g/L（OR=0.689，95% CI为0.536~0.886）、25羟维生素D≥30 nmol/L（OR=0.744，95% CI为0.555~0.996）为CKD患者发生结核分枝杆菌感染的保护性因素，年龄≥60岁（OR=1.863，95% CI为1.286~2.698）、有结核病接触史（OR=1.654，95% CI为1.183~2.312）、有吸烟史（OR=1.895，95% CI为1.300~2.760）、使用抗生素种数>2种（OR=2.250，95% CI为1.328~3.812）、使用免疫抑制剂（OR=2.065，95% CI为1.417~3.008）为CKD患者发生结核分枝杆菌感染的危险因素（P < 0.05）。
结论 CKD患者结核分枝杆菌感染率较高，主要受患者性别、血浆白蛋白水平、25羟维生素D水平、年龄、结核病接触史、吸烟史、使用抗生素种数、免疫抑制剂使用情况的影响。

Abstract:
Objective To analyze the prevalence and related factors of Mycobacterium tuberculosis infection in patients with chronic kidney disease(CKD).
Methods A total of 327 CKD patients were selected as research objects. The factors that may affect CKD patients with Mycobacterium tuberculosis infection were collected, and the patients were divided into two groups according to whether they were combined with Mycobacterium tuberculosis infection or not. The above-mentioned factors were compared between the two groups, and the comprehensive effect of each factor was judged by multivariate Logistic regression analysis.
Results A total of 63 cases (19.27%) of 327 CKD patients in this survey were infected by Mycobacterium tuberculosis. The results of multivariate Logistic regression analysis showed that female (OR=0.710, 95%CI, 0.526 to 0.959), serum albumin ≥35 g/L (OR=0.689, 95%CI, 0.536 to 0.886), 25-hydroxyvitamin D≥30 nmol/L (OR=0.744, 95%CI, 0.555 to 0.996) were protective factors for Mycobacterium tuberculosis infection in CKD patients, while age ≥60 (OR=1.863, 95%CI, 1.286 to 2.698), history of exposure to tuberculosis (OR=1.654, 95%CI=1.183~2.312), history of smoking (OR=1.895, 95%CI, 1.300 to 2.760), types of antibiotics usage>2 (OR=2.250, 95%CI, 1.328 to 3.812), the use of immunosuppressive agents (OR=2.065, 95%CI, 1.417 to 3.008) were risk factors (P < 0.05).
Conclusion The infection rate of Mycobacterium tuberculosis in CKD patients is relatively high, which is mainly affected by the patient's gender, serum albumin, 25-hydroxyvitamin D, age, history of tuberculosis exposure, smoking history, types of antibiotics, and use of immunosuppressants.

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