Risk Factors,Clinical Features And Clinical Outcomes Of Epstein-Barr Virus Infection In Inflammatory Bowel Disease

Background:Inflammatory bowel disease(IBD)is a non-specific chronic non-specific inflammatory bowel disease,caused by the combination of genes,environment,infection and immune factors.At present,the drugs for IBD are mainly glucocorticoids,immunosuppressive agents,and biological agents.Although this type of multimodal adjust therapy significantly improves the prognosis of IBD,it may cause an increase in Epstein-Barr virus(EBV)infection.And induce EBV-related lymphoid tissue proliferative disorders.Purpose:Observe and analyze the clinical features and clinical outcomes of IBD and EBV infection,and early identify the risk factors for EBV infection,and provide more basis for its clinical treatment.Methods:Based on the above research background and purpose,we retrospectively analyzed 125 cases of IBD patients diagnosed as ulcerative colitis(UC)or Crohn’s disease(CD)concurrent EBV-related diagnosis from Department of Gastroenterology,Nanfang Hospital,Southern Medical University from September 2012 to September 2017 As research object.According to the patients with EBV infection,the recent infection of Epstein-Barr virus was included in the infection group,other patients were included in the non-infected group.The general clinical data such as sex,age,course of disease,body shape and whether smoking were compared between two groups of patients with UC or CD respectively.The clinical characteristics and clinical outcomes were compared between the two groups to assess the risk of EBV infection in UC or CD respectively Factors Logistic regression analysis.SPSS20.0 statistical software was used to analyze.The count data was expressed as[n(%)],and the Chi-square test was used.The measurement data were expressed(?)±s,T test was used to analyze the risk factors of EBV infection in UC or CD respectively.Multivariate regression analysis showed that the test level was set as α=0.05,p<0.05 was considered statistically significant.Results:Among the 74 UC patients,11 cases of EBV infection were detected,the infection rate was 14.86%.The improvement rates of infected and uninfected groups were 36.36%and 73.02%,respectively,with statistical significance(p<0.05);51 cases of CD patients were detected in 11 cases of EBV infection,The infection rate was 21.57%,The improvement rates of infected and uninfected groups were 45.45%and 77.50%,respectively,The difference was statistically significant(p<0.05).In a univariate analysis of possible risk factors for EBV infection in IBD patients,Assessment of glucocorticoids,immunosuppressants,and C-reactive protein levels before EBV infection is a risk factor for EBV infection in UC patients(p<0.05);evaluation of EBV infection before use of glucocorticoids,immunosuppressive agents,and weight loss is a risk factor for EBV infection in CD patients(p<0.05).Further using Logistic multivariate regression analysis,in UC patients,evaluating corticosteroids before EBV infection is an independent risk factor for EBV infection(p<0.05);evaluation of EBV infection using immunosuppressants and weight loss is an independent risk factor for EBV infection in CD patients(p<0.05).Conclusion:Assessment of glucocorticoids,immunosuppressants,and high levels of Creactive protein before EBV infection may increase the risk of EBV infection in UC patients,however,assessing EBV infection before using glucocorticoids is an independent risk factor for EBV infection;In patients with CD,assessing glucocorticoids,immunosuppressants,and weight loss prior to EBV infection may increase the risk of EBV infection,however,the use of immunosuppressive agents prior to EBV infection and weight loss are independent risk factors for EBV infection;at the same time,the majority of UC patients and CD patients have poor prognosis after EBV infection.Therefore,we should pay close attention to the prevention of EBV infection and the supportive treatment of antiviral syndrome in IBD patients.