系统性红斑狼疮合并深部真菌感染影响因素分析  

Influencing factors for deep fungal infection in patients with systemic lupus erythematosus

作　　者：王川颖[1] 单葵 胡芳君[1] WANG Chuan-ying;SHAN Kui;HU Fang-jun(Huaian Maternal and Child Health-Care Hospital,Huaian,Jiangsu 223002,China)

机构地区：[1]江苏省淮安市妇幼保健院医疗美容科,江苏淮安223002 [2]重庆市中医院皮肤美容科,重庆400021

出　　处：《中华医院感染学杂志》2019年第14期2130-2133,共4页Chinese Journal of Nosocomiology

基　　金：江苏省科技创新与成果转化自然科学基金资助项目(BK2011849)

摘　　要：目的分析系统性红斑狼疮(SLE)继发深部真菌感染患者临床病症及影响因素。方法回顾性分析2012年12月-2017年12月在医院接受治疗SLE患者589例,有88例合并深部真菌感染,记录患者感染率和感染发生部位,对感染患者行病原菌和耐药检测,对影响真菌感染相关因素行单因素与Logistic回归分析。结果 589例患者中88例发生深部真菌感染,感染率为14.94%,其中33例为肺部感染,占比37.50%(33/88),18例为消化道感染,占比20.45%(18/88),17例为泌尿道感染,占比19.32%(17/88),11例为血液系统感染,占比12.50%(11/88),9例为中枢神经系统感染,占比10.23%(9/88)。真菌感染患者在住院时间、白细胞计数、器官受损累及数、使用抗菌药时间、24 h尿蛋白定量、CD4^+含量、狼疮活动度方面对比差异有统计学意义(P<0.05)。住院时间>4周、24 h尿蛋白量≥3.5 g、白细胞计数≥3×10^9/L、抗菌药物使用时间≥2周及CD4^+≤200个/微升为影响患者真菌感染独立危险因素。结论影响SLE患者真菌感染独立危险因素为住院时间、24 h尿蛋白量、白细胞计数、抗菌药物使用时间及CD4^+含量,值得临床给予关注。OBJECTIVE To investigate the clinical characteristics and influencing factors for deep fungal infection in patients with systemic lupus erythematosus(SLE). METHODS A total of 589 patients with SLE who were treated in hospitals from Dec 2012 to Dec 2017 were retrospectively analyzed, 88 of whom were complicated with deep fungal infection, the incidence of infection and infection sites were recorded, the pathogens isolated from the patients with the infection were identified, the drug resistance was detected, and univariate analysis and logistic regression analysis were performed for related factors for the fungal infection. RESULTS Of the 589 patients, 88 had deep fungal infection, with the infection rate 14.94%, 33 of whom had pulmonary infection, accounting for 37.50%(33/88), 18 had gastrointestinal tract infection, accounting for 20.45%(18/88), 17 had urinary tract infection, accounting for 19.32%(17/88), 11 had blood system infection, accounting for 12.50%(11/88), and 9 had central nervous system infection, accounting for 10.23%(9/88). There were significant differences in the length of hospital stay, white blood cell counts, number of damaged organs involved, time of use of antibiotics, 24-hour urine protein quantitation, CD4^+ content and activity of lupus among the patients with fungal infection( P<0.05). The length of hospital stay more than 4 weeks, 24-hour urine protein content no less than 3.5 g, white blood cell counts no less than 3×10^9/L, time of use of antibiotics no less than 2 weeks and CD4^+ counts no more than 200/μl were the independent risk factors for the fungal infection. CONCLUSION The length of hospital stay, 24-hour urine protein content, white blood cell counts, time of use of antibiotics and CD4^+ counts are the independent risk factors for the fungal infection in the SLE patients, which should be attached great importance to.

关 键 词：系统性红斑狼疮 真菌感染 耐药性 影响因素 

分 类 号：R593.24[医药卫生—内科学]