Clinical Characteristics And Treatment Of Ulcerative Colitis Combined With CMV Infection

Objective:To explore the clinical characteristics,related risk factors and treatment effects of patients with cytomegalovirus(Cytomegalovirus,CMV)infection in ulcerative colitis(ulcerative colitis,UC).To provide some experience and guidance for the clinical diagnosis and treatment of patients with ulcerative colitis.Methods:For retrospective analysis of all UC patients hospitalized for the first time in our hospital from October 2012 to October 2022,they will be divided into the following two groups according to the normal discharge criteria and CMV infection: CMV-positive group and CMV-negative group.General data,clinical characteristics,laboratory tests,endoscopic characteristics,treatment and prognosis of both groups were retrospectively analyzed.The above was studied by univariate analysis,then screened variables by stepwise method to further explore the relevant risk factors of CMV infection in UC patients by Logistic multivariate regression analysis.Results:From October 2012 to October 2022,a total of 197 UC patients were first hospitalized in our hospital,among which 44 patients had CMV infection,with the infection positive rate as high as 22.3%(44 / 197).In the comparison of general data,the average age of the CMV positive group was(52.11 ± 17.97),and the mean age of the CMV negative group was(52.08± 15.1).The proportion of the positive group and the negative group was close.There was no significant statistical difference between the two groups(P=0.992).The sex ratio of the CMV positive group was(25 / 19)and the CMV negative group was(80 / 73).Although the two groups were mostly male patients,the difference was not significant(P=0.277).The median length of hospital stay in the CMV positive group was 16(13,23)days,longer than that in the CMV negative group of 11(7,14)days,with significant differences between the positive and negative groups(P <0.001).There were no significant differences in fever,abdominal pain,diarrhea,stool,mucus,pus and stool,respectively(P> 0.05).In the CMV positive group,56.82%(25 / 44)and 34.64%(53 / 153)were lost in the CMV negative group,which were statistically significant(P=0.008).In terms of disease severity,the CMV positive group accounted for 63.64%(28 / 44),severe patients 36.36(16 / 44),CMV negative patients81.70%(125 / 153)and severe patients 18.30(28 / 153),the two groups were statistically significant(P=0.011).Comparison in electronic colonoscopy: No difference in the comparison between crypt abscess and cryitis(P> 0.05).Comparison of laboratory indicators:in the comparison of leukocytes,platelets,sedimentation and C reactive protein,There was no significant difference between patients in the two groups(P> 0.05);The mean hemoglobin value of patients in the CMV positive group was(99.21 ± 20.51)g / L,The mean hemoglobin value of patients in the CMV negative group was(110.37 ± 18.61)g / L,There was a significant difference between the two groups(P=0.001);The mean albumin value of the CMV positive group was(30.77 ± 6.64)g / L,The mean albumin value of patients in the CMV negative group was(35.45 ± 5.68)g / L,There was significant differences between the two groups(P <0.001).Drug use: amino salicylic acid,biological agents,immunosuppressive agents(P> 0.05);54.5% in the CMV positive group;54.55%(24 / 44),29.41%(45 / 153)in the CMV negative group(P=0.002).Of the 44 UC patients with CMV positive,20.5%(9 / 44)and 79.5%(35 / 44),showed statistically significant differences between the two groups of early clinical remission and repeated visits in the short term(P <0.05).Conclusion:First,Body weight loss,longer hospital stay,use of glucocorticoids and severe UC should be vigilant whether patients are infected with CMV.Second,low hemoglobin,low albumin,glucocorticoid use and severe UC are related risk factors for CMV infection.Third,antiviral therapy has obvious clinical effect on UC combined with CMV treatment.Fourth,For the object and timing of antiviral,the need for antiviral should be determined according to the intestinal mucosal tissue or the CMV DNA viral load in plasma.Fifth,With the development trend of biologic agents,drugs led by Veridizumab have high clinical response rate,clinical remission rate and mucosal healing rate in the treatment of moderate and severe UC.