肿瘤坏死因子拮抗剂治疗炎性关节炎与患者冬季上呼吸道感染的相关研究

目的：分析应用肿瘤坏死因子拮抗剂治疗炎性关节炎患者冬季发生上呼吸道感染的风险以及治疗对其免疫功能的可能影响。方法：选择2009年9月—2010年1月在复旦大学附属中山医院接受肿瘤坏死因子拮抗剂治疗的29例患者（包括强直性脊柱炎及类风湿关节炎,定义为A组）,同期纳入未接受或者2009年9月起已经停用该药的31例患者（包括强直性脊柱炎、类风湿关节炎、系统性红斑狼疮、多发性大动脉炎等,定义为B组）。收集患者基本资料和调查其冬季上呼吸道感染的发生情况。结果：A组发生上呼吸道感染10例,频数13次;B组发生9例,频数11次,两者之间的差别无统计学意义（P〉0.05）,且A、B组因上呼吸道感染静脉用药情况亦无显著差异（P〉0.05）;根据既往有无应用肿瘤坏死因子拮抗剂治疗将B组分为两个亚组B1、B2,与A组相比,上呼吸道感染的发生率亦无显著差别（P〉0.05）。结论：肿瘤坏死因子拮抗剂的应用未使冬季上呼吸道感染的风险增加,其治疗炎性关节炎的安全性较好。

The Relationship between Tumor Necrosis Factor Antagonists Treatment of Inflammatory Arthritis and Upper Respiratory Tract Infection in Winter

Objective：To study the risk of upper respiratory tract infection and the immune function in inflammatory arthritis patients treated with tumor necrosis factor antagonists in winter.Methods： Twenty-nine patients were treated with tumor necrosis factor antagonists（including ankylosing spondylitis and rheumatoid arthritis,defined as Group A）.Thirty-one patients did not accept or had been stopped this treatment since September 2009（including ankylosing spondylitis,rheumatoid arthritis,systemic lupus erythematosus,polyarteritis,et al,defined as Group B）.The basic information were collected and the occurrence of upper respiratory tract infection in winter were investigated.Results： In Group A,10 cases of upper respiratory tract infection occurred,frequency was 13.In Group B,9 cases occurred,frequency was 11.The differences between the two groups were not significant（P 0.05）.There was also no significant difference about the intravenous drug use due to upper respiratory tract infection between the two groups（P 0.05）.There was also no significant difference about the incidence of upper respiratory tract infection between Group A,B1 and B2（P 0.05）.Conclusions： In winter,tumor necrosis factor antagonists treatment does not increase the risk of upper respiratory tract infection in inflammatory arthritis patients.