189例狼疮性肾炎并发感染的临床分析  

Clinical analysis of infectious complications in 189 patients with lupus nephritis

作　　者：王荔[1] 夏天[1] 赵爱国[1] 张洪震[2] 

机构地区：[1]天津医科大学第二医院肾内科,300211 [2]天津医科大学第二医院检验科,300211

出　　处：《中国医师进修杂志》2016年第4期311-314,共4页Chinese Journal of Postgraduates of Medicine

摘　　要：目的分析狼疮性肾炎（LN）治疗过程中并发感染的临床特点和流行病学特征。方法回顾性分析189例LN首次确诊患者，随访1年感染的发生率、感染部位，病原体种类，以及LN临床、病理类型和治疗方案与感染的关系。结果189例LN患者中男16例，女173例；发生感染97例（感染组），发生率为51．3％（97／189），院内感染发生率为39．7％（75／189）；未发感染92例（非感染组）。感染组患者共发生感染133例次，感染部位以肺部和泌尿道为主，占67．7％（90／133）；病原体以细菌最常见，占72．9％（97／133），其次为病毒，占17．3％（23／133）。临床类型、病理类型及治疗方案不同，感染发生率也不同，但差异无统计学意义（P〉0．05）。激素＋环磷酰胺双冲击治疗院内感染率明显高于激素＋吗替麦考酚酯治疗[52．9％（45／85）比7．7％（2，26）]，差异有统计学意义（P〈0．叭）。随访1年，感染组病死率明显高于非感染组[8．2％（8／97）比1．1％（1／92）]，差异有统计学意义（P〈0．05）。结论临床病理类型严重的LN患者感染发生率高，不同治疗方案的感染发生率不同。感染仍是LN患者死亡的最主要原因。Objective To investigate the clinical and epidemiologic features of infection in patients with lupus nephritis （LN）. Methods The incidence, sites and pathogen species of infection 1 year after diagnosis in 189 patients with LN were retrospectively analyzed, and the relationships between the clinical, histological types, treatment programs and infection were analyzed. Results Among 189 LN patients （16 males and 173 females）, 97 patients had infection （infection group）, and 92 patients had not infection （non-infection group）. The incidence of infection was 51.3% （97/189）, while the incidence of nosocomial infection was 39.7% （75/189）. In infection group, the patients had 133 infection episodes, and the principal infection sites were lung and urinary tract system, accounting for 67.7% （90/133）; the principal pathogen was bacteria, accounting for 72.9% （97/133）, and the second was virus, accounting for 17.3% （23/133）. Different clinical or pathological types and treatment options of LN had different infection rates, but there were no statistical differences （P 〉 0.05）. The incidence of nosocomial infection in patients with glueoeortieoid ＋ eyclophosphamide double impact was significantly higher than that in patients treated with glueocortieoid ＋ myeophenolate mofetil： 52.9% （45/85） vs. 7.7% （2/26）, and there was statistical difference （P〈0.01）. One year after diagnosis, the mortality in infection group was significantly higher than that in non-infection group： 8.2% （8/97） vs. 1.1% （1/92）, and there was statistical difference （P 〈 0.05）. Conclusions The more serious the clinical and pathological types, the higher the incidence of infection. The incidence of infection is associated with the treatment options. Infection is still the most important reason for LN patients＇ death.

关 键 词：狼疮肾炎 感染 回顾性研究 

分 类 号：R593.242[医药卫生—内科学]