Clinical Features Of Ulcerative Colitis With CMV And EBV Viremia

Objective:To investigate the clinical features of ulcerative colitis(UC)with Cytomegalovirus(CMV)and Epstein-barr virus(EBV)viremia.Method:A total of 320 inpatients with ulcerative colitis in Department of Gastroenterology,Second Hospital of Hebei Medical University from January2014 to January 2019 were collected as the study subjects.According to the responsible pathogens,the patients were divided into four groups:35 patients infected with EBV and CMV viremia,33 infected with CMV viremia and 52infected with EBV viremia and 200 patients infected without EBV and CMV viremia.Furthermore,a retrospective case-control study was employed to compare the clinical characteristics and prognosis with SPSS 22.0 software.Results:A total of 320 UC patients were enrolled in this study,including that35(10.94%)UC patients were infected with EBV and CMV viremia,33(10.31%)UC patients were infected with CMV viremia,52(16.25%)UC patients were infected with EBV viremia and 200 UC patients were infected without EBV and CMV viremia.1.Age>60 years old,previous application of glucocorticoids and glucocorticoids ineffectiveness were associated with UC with CMV and EBV viremia(x~2=17.062,P=0.000;x~2=10.598,P=0.001;x~2=29.769,P=0.000);regardless of gender,previous application of 5-ASA,glucocorticoids,azathioprine and infliximab.2.The group with EBV and CMV viremia can perform fever,abdominal pain,blood in the stool,weight loss,disease activity,lesions expanded,serum albumin less than 30g/L,and hemoglobin less than 100g/L.The incidences of all performances were higher than the group without CMV and EBV viremia,and there was significant difference(x~2=31.475,P=0.000;x~2=27.945,P=0.000;x~2=32.93,P=0.000;x~2=5.10,P=0.002;x~2=40.194,P=0.000;Fisher exact probability P=0.002;x~2=44.242,P=0.000;x~2=15.22,P=0.000).There was no significant difference in the course of the disease.Compared with group with CMV or EBV viremia,above all performances were no significant difference.3.The incidence of deep ulcer,irregular ulcer and longitudinal ulcer in the group with EBV and CMV viremia was significantly higher than that in the group without EBV and CMV viremia(x~2=72.521,P=0.000;x~2=49.837,P=0.000;Fisher exact probability P=0.006),but there was no significant difference in mucosal defect;Compared with group with EBV viremia,the incidence of deep ulcers and irregular ulcers was significantly higher,the difference was statistically significant(x~2=9.663,P=0.002;x~2=11.206,P=0.001),but there was no significant difference in the incidence of longitudinal ulcers.Compared with group with CMV viremia,there was no significant difference in the incidence of mucosal defect,deep ulcers,irregular ulcers,and longitudinal ulcers under endoscopy.4.Compared with the group with CMV or EBV viremia,the antiviral failure rate in the group with CMV and EBV viremia was significantly higher(x~2=6.989,P=0.008;x~2=6.310,P=0.012;P<0.0125)and the prognosis was the worst(x~2=8.172,P=0.004;x~2=8.558,P=0.003).Conclusion:1.UC patients whose age more than 60 years old,previous glucocorticoid therapy and glucocorticoid ineffective should be highly vigilant the occurrence of CMV and EBV viremia;2.UC patients who were infected with CMV and EBV viremia can aggravate their condition,performing that fever,abdominal pain,blood in the stool,weight loss,enlarged lesions,and increased ALB less than 30g/L,HGB less than 100g/L,and clinical manifestations of UC with CMV or EBV viremia were similar;3.Endoscopic can be characterized by deep ulcers,irregular ulcers,and longitudinal ulcers when UC patients who were infected with CMV and EBV viremia.and endoscopic features were similar to UC with CMV viremia;4.Compared with patients with CMV or EBV viremia,the antiviral failure rate in patients who were infected with CMV and EBV viremia was higher and the prognosis was worst.