系统性红斑狼疮合并深部真菌感染临床分析  

Deep fungal infections in patients with systemic lupus erythematosus： a clinical analysis

作　　者：陈晓[1] 付睿[3] 胥杰[2] 曾小峰[4] 马小军[5] 

机构地区：[1]首都医科大学附属北京同仁医院南区风湿科,100176 [2]首都医科大学附属北京同仁医院呼吸科,100176 [3]北京世纪坛医院神经科 [4]中国医学科学院北京协和医院风湿免疫科 [5]中国医学科学院北京协和医院感染科

出　　处：《中华风湿病学杂志》2009年第3期159-161,共3页Chinese Journal of Rheumatology

基　　金：国家科技支撑计划基金（2008BA59802）

摘　　要：目的探讨系统性红斑狼疮（SLE）合并深部真菌感染的部位、菌种、诊断及预后。方法回顾性分析北京协和医院2000-2006年住院治疗的1466例SLE患者中合并深部真菌感染的51例患者的临床资料。结果合并深部真菌感染51例SLE患者，感染的病原菌以白色念珠菌为主，其次为隐球菌和曲霉菌。感染最常见的部位是肺，其次为脑膜和血液。本组病例中死亡10例，病死率达20％。曲霉菌感染者病死率高达4／5。低蛋白血症、多部位真菌感染、曲霉菌感染、真菌血症可能是导致SLE患者死亡的独立危险因素。结论SLE合并真菌感染的主要部位为肺，感染的病原菌以白色念珠菌为主；临床应重视早期诊断和曲霉菌感染。Objective To investigate the infection sites,the offending species, diagnosis and prognosis of deep fungal infections （DFI） in patients with systemic lupus erythcmatosus （SLE）. Methods Fifty-one patients with fungal infections in 1466 SLE patients admitted to Peking Union Medical College （PUMC） Hospital from 2000 to 2006 were reviewed retrospectively. Results Candida albicans was ranked the first pathogen, followed by neoformans and Aspergillus species. The infection sites were lungs, cerebral meninges and blood in the order of prevalence. The overall mortality was 20%（ 10/51 ）. Aspergillasis carried the highest mortality which could be as high as 80%. Hypoproteinemia,muhiple focus of fungal infections, Aspergillasis and fungemia might be the independent risk factor for mortality. Conclusion Candida albicans is the most frequent species of fungal infections in SLE patients, lungs are the most prevalent location of infection. Earlier diagnosis is important. Special attention should be paid to aspergillasis.

关 键 词：红斑狼疮 系统性 真菌感染 死亡率 曲霉菌 

分 类 号：R686[医药卫生—骨科学]