大疱性类天疱疮患者感染分析  

Infections in patients with bullous pemphigoid

作　　者：楼小航[1] 刘继峰[1] 吴纪龙[1] 邢臣径[1] 陈娜[2] 

机构地区：[1]杭州市第三人民医院皮肤科,浙江杭州310009 [2]杭州市第三人民医院康复科,浙江杭州310009

出　　处：《中华医院感染学杂志》2017年第9期2009-2011,2019,共4页Chinese Journal of Nosocomiology

基　　金：浙江省卫生厅基金资助项目(2013KYB2690)

摘　　要：目的探讨大疱性类天疱疮患者的感染情况,并分析诱发感染的相关危险因素,为临床治疗提供参考。方法对杭州市第三人民医院收治的大疱性类天疱疮患者116例临床资料进行回顾性分析,所有患者均根据病情轻重程度选取个体化治疗方案,以糖皮质激素治疗为主,并积极给予其他相关治疗;观察并记录患者的转归及感染情况,分析感染率与年龄、性别、血白蛋白水平、病情严重程度的关系。结果 116例患者中,病情缓解110例,缓解率为94.83%,不详者5例,死亡1例,病死率为0.86%;重症患者缓解率(83.33%)明显低于中轻症患者(100.00%),差异有统计学意义(P<0.05);116例患者中,发生感染25例,感染率为21.55%;其中细菌感染24例,感染率为20.69%;真菌感染4例,感染率为3.45%;感染部位包括皮肤感染19例,肺部感染3例,败血症2例,尿路感染3例,口腔感染4例;其中合并2种感染2例(中症1例,重症1例),合并3种感染2例(均为重症);共分离出病原菌31株,主要病原菌为金黄色葡萄球菌、溶血葡萄球菌、大肠埃希菌和白念珠菌,分别占35.48%、19.35%、16.13%、12.90%;患者感染率与病情程度及血白蛋白水平有关,血白蛋白水平较低者感染率(35.29%)大于血白蛋白水平较高者(15.85%);重症大疱性类天疱疮感染率(44.44%)大于中症(11.48%)、轻症(10.53%)患者。结论大疱性类天疱疮患者合并感染发病率较高,感染率与病情程度和血白蛋白水平有明显相关性;病原菌以金黄色葡萄球菌最为常见,在临床工作中,要重视此类患者的皮肤护理及感染防控。OBJECTIVE To explore the prevalence of infections in patients with bullous pemphigoid and analyze the related risk factors for the infections so as to provide guidance for clinical treatment.METHODS A total of 116 patients with bullous pemphigoid who were treated in the Third People′s Hospital of Hangzhou were enrolled in the study,the clinical data of the enrolled patients were retrospectively analyzed,all the patients were given individualized treatment plans according to the severity of disease,which was dominated by glucocorticoids therapy and was accompanied by other therapies.The treatment outcomes and prevalence of infection in the patients were observed and recorded,and the relationship between the infection rate and the age,gender,serum albumin level,and severity of disease was analyzed.RESULTS Of the 116 patients,110recovered,with the recovery rate 94.83%,5were unknown,and 1died,with the mortality rate 0.86%.The recovery rate of the severe patients was 83.33%,significantly lower than 100.00% of the moderate and mild patients（P〈0.05）.Of the 116 patients,25had infections,with the infection rate 21.55%;24had bacterial infections,with the infection rate 20.69%,and 4had fungal infections,with the infection rate 3.45%.There were 19 cases of skin infections,3cases of pulmonary infections,2cases of sepsis,3cases of urinary tract infections,and 4cases of oral infections;there were 2patients complicated with two types of infections（1moderate case,1severe case）,and 2patients complicated with three types of infections（all were severe cases）.Totally 31 strains of pathogens were isolated;Staphylococcus aureus,Staphylococcus haemolyticus,Escherichia coli,and Candida albicans were dominant among the isolated pathogens,accounting for 35.48%,19.35%,16.13%,and 12.90%,respectively.The prevalence rate of infection was associated with the serum albumin level,the infection rate of the patients with low level of serum albumin was 35.29%,higher than 15.85% of the patients with high level of serum albumin;the inf

关 键 词：大疱性类天疱疮 感染 转归 金黄色葡萄球菌 

分 类 号：R373[医药卫生—病原生物学]