系统性红斑狼疮继发深部真菌感染的临床研究  

Clinical study of invasive fungal infection secondary to systemic lupus erythematosus

作　　者：邓红香[1] 游运辉[1] 刘萍 赵洪军[1] 周亚欧[1] 谢艳莉[1] 左晓霞[1] 

机构地区：[1]中南大学湘雅医院风湿免疫科,长沙410008 [2]长沙市第一医院呼吸科,长沙410005

出　　处：《中南大学学报（医学版）》2013年第2期182-185,共4页Journal of Central South University ：Medical Science

基　　金：十一五科技支撑计划(2008BAI59B02);湖南省科技厅计划项目(2010FJ3086);中南大学研究生自主探索创新基金~~

摘　　要：目的:探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)继发深部真菌感染的临床特点。方法:对中南大学湘雅医院近年收治的48例合并深部真菌感染的SLE患者及41例未合并感染的SLE患者进行临床观察研究。结果:SLE合并深部真菌感染的部位以肺部、神经系统、泌尿系统为主,致病真菌以白色念珠菌、曲霉菌为主。随着病程、免疫抑制药及抗生素使用时间的延长,低蛋白血症、白细胞减少等合并症的出现,SLE患者深部真菌感染的发生率明显增加,SLE继发深部真菌感染的患者C反应蛋白(CRP)及肿瘤坏死因子α(TNF-α)水平均明显增高。结论:发生深部真菌感染的SLE患者主要的临床特点是病程长,免疫抑制药或抗生素使用时间长,合并有低蛋白血症及白细胞减少等。CRP及TNF-α这两项指标在真菌感染中可能有重要作用,可作为诊断真菌感染的参考指标。Objective： To study the clinical characteristics of invasive fungal infection secondary to systemic lupus erythematosus （SLE）.Methods： We observed the clinical features and experimental examination in 91 patients treated in Xiangya Hospital in recent years, of which 48 patients with invasive fungal infection and 41 patients without invasive fungal infection. Results： The invasive fungal infection secondary to SLE mainly occurred in the lungs, nervous system, and urinary system. The fungi were mainly Candida albins and Aspergillus. The rate of invasive fungal infection in SLE patients and the level of CRP and TNF-α in these patients were significantly increased. The occurrence of invasive fungal infection was positively correlated with the prolonged course of disease, long-term use of immunosuppressants and antibiotics, and occurrence of complications, such as hypoproteinemia, leukocytopenia, and so on. The levels of C-reactive protein （CRP） and tumor necrosis factor-α（TNF-α） were increased in SLE patients with invasive fungal infection.Conclusion： The clinical features of SLE patients with invasive fungal infections are long course of disease, long-time use of immunosuppressants or antibiotics, and occurrence of complications, such as hypoproteinemia or leukopenia. The level of CRP and TNF-α can be used as an important reference index for diagnosing invasive fungal infections.

关 键 词：系统性红斑狼疮 深部真菌感染 临床研究 

分 类 号：R593.241[医药卫生—内科学]