系统性红斑狼疮患者感染的临床特点及危险因素  

Clinical characteristics and risk factors of co-infection in patients with systemic lupus erythematosus

作　　者：梅珏[1] 陈士芳[1] 王笑颜[1] 王友庆[1] 陶渊璆 

机构地区：[1]湖州市中心医院风湿免疫科,浙江湖州313000

出　　处：《中华医院感染学杂志》2013年第23期5698-5700,共3页Chinese Journal of Nosocomiology

基　　金：湖州市科技局计划基金项目(2012YSB20)

摘　　要：目的探讨系统性红斑狼疮(systemic lupus erythematosus,SLE)患者发生医院感染临床特点及危险因素,为降低医院感染的发生提供参考。方法回顾性分析2005年1月-2012年12月106例SLE患者临床资料,将其按照有无感染分为感染组与非感染组,临床特点及危险因素采用多因素logistic回归分析。结果 106例SLE患者发生感染者34例、43例次,感染率32.08%、例次感染率40.57%,其中呼吸系统、泌尿系统、皮肤软组织、中枢神经系统、败血症及消化系统感染分别占47.06%、26.47%、17.65%、2.94%、2.94%、2.94%;43例次感染中检出病原体43株,其中细菌、真菌、病毒、支原体属分别占72.09%、11.63%、9.30%、4.65%;感染组与非感染组在年龄、病程疾病活动性、住院时间、白细胞、血清白蛋白、C3、C-反应蛋白、血沉、24h尿蛋白定量、使用环磷酰胺累积量及使用泼尼松日剂量比较,差异有统计学意义(P<0.05);logistic多因素回归分析显示,住院>14d、C3降低、24h尿蛋白定量升高、疾病活动性、泼尼松日剂量大、环磷酰胺累积量大是引起感染的独立危险因素(P<0.05)。结论 SLE患者容易发生感染,感染部位主要为呼吸系统感染,感染病原体以细菌为主,住院时间长、C3降低、24h尿蛋白定量升高、疾病活动性、泼尼松日剂量大、环磷酰胺累积量大是引起SLE患者感染发生的危险因素,临床应进行干预,以降低感染的发生。OBJECTIVE To investigate the clinical characteristics and risk factors of patients with systemic lupus erythematosus （SLE） combined nosocomial infection, and provide the basis for reducing the incidence of nosocomi-al infection. METHODS A retrospective analysis was conducted on the clinical data of 106 SLE patients from Jan 2005 to Dec 2012, and were divided into infection group and non infection group according to having or not having co-infeetion, and the clinical characteristics and risk factors were analyzed using multi-factor analysis method. RESULTS In 106 cases of SLE patients, infection were found in 34 cases and 43 case-times, with the infection rate of 32.08% and case infection rate of 40. 57%, among which the infection rates of respiratory system, urinary system, skin soft tissue, central nervous system, sepsis, and digestive system infection were 47.06%, 26.47%, 17.65%, 2.94%, 2.94%, 2.94%, respectively; 43 pathogens were detected in 43 case-times, of which bacteria, fungi, virus, mycoplasma were 72. 09%, 11. 63%, 9. 30% , 4. 65%; the differences of age, course of disease activity, length of hospilal stay, white blood cells, serum albumin, C3, C reaction protein, sedimentation, 24 h urine protein quantitative, cumulant of cyclophosphamide （CTX） and daily dose of prednisone （PDN） between infection group and non-infection group had statistical significance （P〈 0.05）; Logistic multifactor regression analysis showed that the longer than 14 days of hospital stay, decrease of C3, increase of 24 h urine protein quantization, disease activity, larger PDN daily dose, larger CTX cumulant were independent risk factors that caused SLE patients co-infection （P〈0.05）. CONCLUSION Patients with SLE are likely to be co-infected, with main infection sites of the respiratory system and the main pathogens of bacteria. Long hospital stay, decrease of C3, increase of 24 h urine protein quantitation, disease activity, large PDN daily dose and large CTX cumulant are independent risk factors that cause

关 键 词：系统性红斑狼疮 感染 临床特点 危险因素 

分 类 号：R181.32[医药卫生—流行病学]