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首页> 外文期刊>Modern rheumatology >Clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis receiving adalimumab: A retrospective review and case-control study of 17 patients
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Clinical characteristics and risk factors for Pneumocystis jirovecii pneumonia in patients with rheumatoid arthritis receiving adalimumab: A retrospective review and case-control study of 17 patients

机译：阿达木单抗治疗的类风湿关节炎肺炎支原体肺炎的临床特征和危险因素：17例回顾性研究与病例对照研究

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摘要

Objectives: To investigate the clinical characteristics and risk factors of Pneumocystis jirovecii pneumonia (PCP) in rheumatoid arthritis (RA) patients treated with adalimumab. Methods: We conducted a multicenter, retrospective, case-control study to compare RA patients treated with adalimumab with and without PCP. Data from 17 RA patients who were diagnosed with PCP and from 89 RA patients who did not develop PCP during adalimumab treatment were collected. Results: For the PCP patients, the median age was 68 years old, with a median RA disease duration of eight years. The median length of time from the first adalimumab injection to the development of PCP was 12 weeks. At the onset of PCP, the median dosages of prednisolone and methotrexate were 5.0 mg/day and 8.0 mg/week, respectively. The patients with PCP were significantly older (p < 0.05) and had more structural changes (p < 0.05) than the patients without PCP. Computed tomography of the chest revealed ground-glass opacity without interlobular septal boundaries in the majority of the patients with PCP. Three PCP patients died. Conclusions: PCP may occur early in the course of adalimumab therapy in patients with RA. Careful monitoring, early diagnosis, and proper management are mandatory to secure a good prognosis for these patients.
机译：目的：探讨阿达木单抗治疗的类风湿关节炎（RA）患者的吉氏肺孢子虫肺炎（PCP）的临床特征和危险因素。方法：我们进行了一项多中心，回顾性，病例对照研究，比较接受阿达木单抗治疗和未治疗PCP的RA患者。收集了17例经诊断为PCP的RA患者和89例在阿达木单抗治疗期间未发生PCP的RA患者的数据。结果：对于PCP患者，中位年龄为68岁，中位RA病程为8年。从第一次阿达木单抗注射到PCP形成的平均时间长度为12周。在PCP发作时，泼尼松龙和甲氨蝶呤的中位剂量分别为5.0毫克/天和8.0毫克/周。与没有PCP的患者相比，PCP的患者明显更年长（p <0.05），并且结构变化更大（p <0.05）。胸部X线计算机断层扫描显示，大多数PCP患者的磨玻璃片混浊没有小叶间隔。三名PCP患者死亡。结论：RA患者的阿达木单抗治疗过程中可能发生PCP。为了确保这些患者的良好预后，必须进行仔细的监测，早期诊断和适当的管理。

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