系统性红斑狼疮患者并发社区获得性肺炎的危险因素分析  

Analysis of risk factors of patients with systemic lupus erythematosus complicated by community-acquired pneumonia

作　　者：陶丽菊[1] 王小超[1] 陈诗强[1] 吕丽娜[1] 李红文[1] 黄丹[1] 

机构地区：[1]右江民族医学院附属医院免疫风湿科,百色533000

出　　处：《右江医学》2014年第4期417-420,共4页Chinese Youjiang Medical Journal

摘　　要：目的 探讨系统性红斑狼疮患者并发社区获得性肺炎的危险因素.方法 选取2011年1月至2013年12月在免疫风湿科住院治疗确诊为系统性红斑狼疮的患者167例,对多项观察指标进行单因素分析和多因素Logistic 回归分析.结果 167例系统性红斑狼疮患者中有51例（30.5％）并发社区获得性肺炎.单因素分析显示：＞3个系统受累、白细胞计数＜2.0×109/L、血浆白蛋白＜25 g/L、连续应用大剂量糖皮质激素治疗（醋酸泼尼松≥1.0 mg·d-1·kg-1,＞4周）、应用超大剂量糖皮质激素冲击治疗（甲泼尼龙500～ 1000 mg/次,连用3天）、大剂量糖皮质激素与免疫抑制剂联合应用、肺间质病变等因素与系统性红斑狼疮并发社区获得性肺炎有关.多因素Logistic回归分析显示：肺间质病变、连续应用大剂量糖皮质激素治疗（醋酸泼尼松≥1.0 mg·d-1·kg-1,＞4周）、应用超大剂量糖皮质激素冲击治疗（甲泼尼龙500～ 1000 mg/次,连用3天）、大剂量糖皮质激素与免疫抑制联合应用是系统性红斑狼疮患者并发社区获得性肺炎的危险因素.结论 有效治疗原发病和正确掌握糖皮质激素和免疫抑制剂的应用原则是防治系统性红斑狼疮患者并发社区获得性肺炎的有效方法.Objective To investigate the risk factors of patients with systemic lupus erythematosus complicated by community-acquired pneumonia.Methods Single factor analysis and multivariate Logistic regression analysis were carried out to the indexes of 167 patients who were diagnosed with systemic lupus erythematosus during their stays in the Department of Immunology ＆ Rheumatology of our hospital from Jan,2011 to Dec,2013.Results Among 167 cases with systemic lupus erythematosus,51 cases （30.5%） were complicated by community acquired pneumonia. Single factor analysis revealed that over 3 systems involved,white cell counts 〈 2.0× 10^9/L, plasma albumin〈 25 g/L, consecutive treatment with large doses of glucocorticoid （prednisone acetate of 1.0 mg· d-1 · kg-1, 〉 4 weeks） plus impact treatment with large doses of glucocorticoid （methylprednisolone was continuously taken 3 days with more than 1000 mg each time）, the combined application of large doses of glucocorticoid and immunosuppression, interstitial lung diseases were related to systemic lupus erythematosus complicated by community acquired pneumonia.The multivariate Logistic regression analysis revealed that interstitial lung diseases, treatment with large doses of glucocorticoid （prednisone acetate of 1.0 mg · d-1 · kg-1 , 〉4 weeks）plus impact treatment with large doses of glucocorticoid （methylprednisolone was continuously taken for 3 days with 500 mg-1000 mg each time.） ,the combined application of large doses of glucocortieoid and immunosuppression were the risk factors of patients with systemic lupus erythematosus complicated by community-acquired pneumonia.Conclusion To treat primary diseases effectively and to master the applied principle of glucocorticoid and immunosuppressant correctly are effective methods to prevent patients systemic lupus erythematosus complicated by community-acquired pneumonia.

关 键 词：系统性红斑狼疮 社区获得性肺炎 危险因素 

分 类 号：R593.241[医药卫生—内科学]