系统性红斑狼疮患者医院感染的危险因素分析  

Risk factors for nosocomial infections in patients with systemic lupus erythematosus

作　　者：余金泉[1] 徐冰凌[2] 刘大钺[3] 杨念生[4] 

机构地区：[1]中山大学附属第一医院医院感染管理科,广东广州510080 [2]中山大学附属第一医院呼吸内科,广东广州510080 [3]中山大学附属第一医院感染管理科,广东广州510080 [4]中山大学附属第一医院风湿内科,广东广州510080

出　　处：《中华医院感染学杂志》2013年第18期4401-4403,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划项目(2008A030201029)

摘　　要：目的探讨系统性红斑狼疮并发医院感染的危险因素,为预防控制医院感染的发生提供参考。方法回顾性分析2011年1月-2012年6月住院的SLE患者,按照是否发生医院感染将其分为感染组和非感染组,比较两组在系统性红斑狼疮疾病活动性指数评分、补体C3水平、浆膜炎情况、白蛋白水平、贫血程度、白细胞减少率、肾功能、激素和免疫抑制剂使用等方面的差异。结果病情中重度活动患者64例中感染34例占53.13%,使用免疫抑制剂治疗患者33例中感染21例占63.64%,与相应对照组比较差异无统计学意义;低C3血症患者70例中感染44例占62.86%,浆膜炎患者52例中感染34例占65.38%,低白蛋白血症患者95例中感染54例占56.84%,中度以上贫血患者47例中感染30例占63.83%,血白细胞减少患者42例中感染27例占64.29%,肾功能不全患者26例中感染20例占76.92%,使用激素治疗患者53例中感染41例占77.36%,与对照组比较差异有统计学意义(P<0.05)。结论低C3血症、浆膜炎、低白蛋白血症、中度以上贫血、血白细胞减少、肾功能不全、使用激素为SLE合并医院感染的危险因素,病情活动、使用免疫抑制剂不会增加感染风险。OBJECTIVE To discuss and analyze the risk factors of nosocomial infections in patients with systematic lupus erythematosus （SLE） so as to provide basis for the prevention and control of nosocomial infections. METHODS The SLE patients who were treated in the hospital from Jan 2011 to Jun 2012 were retrospectively studied. They were divided into the infection group and the non-infection group based on the status of nosocomial infections, then the SLEDAI score, level of C3, albumin and hemoglobin, severity of serositis, neutropenia rate, renal function, and application of glueocorticoid and immunosuppressant were compared between the two groups. RESULTS Totally 34 of 64 cases with moderate to severe disease activity （53.13 %） were with nosocomial infections, and 21 of 33 cases of patients who used immunosuppressant （63.64%） were with nosocomial infections,as compared with the control group, the difference was not significant. Accordingly, 44 of 77 cases were with low C3 level （62.86%）, 34 of 52 were with serositis （65.38%）, 54 of 95 were with hypoalbuminemia （56. 84%）, 30 of 47 were with moderate or severe anemia （63.83%）, 27 of 42 with leucopenia （64.29%）, 20 of 26 cases were with renal dysfunction （76.92%）, and 41 of 53 patients who used glucocorticoid （77.36%） were with nosocomial infections, as compared with the control group, the difference was significant （P〈0.05）. CONCLUSION The risk factors of nosocomial infections in the SLE patients include the low C3 level, serositis, hypoalbuminemia and moderate or severe anemia, leukopenia, and renal dysfunction as well as use of glucocorticoid,meanwhile, the disease activity or the use of immunosuppressant would not increase the risk of infections.

关 键 词：系统性红斑狼疮 医院感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]