系统性红斑狼疮合并带状疱疹患者医院感染的临床特点及其淋巴细胞亚群和CD64指数对预后的影响分析  

Clinical characteristics of nosocomial infection in patients with systemic lupus erythematosus combined with herpes zoster,and analyze the influence of lymphocyte subsets and CD64 index on prognosis

作　　者：张成才[1] 艾志敏[1] 胡娟[1] 陈方明[1] ZHANG Cheng-cai;AI Zhi-min;HU Juan;CHEN Fang-ming(Department of Nephrology,Dazhou Integrated TCM&Western Medicine Hospital,Sichuan,Dazhou 635000,China)

机构地区：[1]达州市中西医结合医院肾病内科

出　　处：《中国医学前沿杂志（电子版）》2020年第2期32-35,共4页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：四川省科技计划项目(2014S710218)

摘　　要：目的分析系统性红斑狼疮合并带状疱疹患者医院感染的临床特点,以及淋巴细胞亚群和CD64指数对其预后的影响。方法选取2017年1月至2017年12月达州市中西医结合医院收治的90例系统性红斑狼疮合并带状疱疹患者为研究对象,回顾性分析患者发生医院感染的临床特点,将发生医院感染的患者,根据感染严重程度分为对照组和观察组,比较两组患者在淋巴细胞亚群和CD64指数上的差异,分析这些差异对患者预后的影响。结果患者发生医院感染的部位主要为呼吸道和皮肤;使用免疫抑制剂、红斑狼疮涉及脏器≥2个、系统性红斑狼疮疾病活动指数(systemic lupus erythematosus disease activity index,SLEDAI)评分>9分、低蛋白血症是患者发生医院感染的独立危险因素(均P<0.05);对照组患者CD3^+T细胞阳性率、CD4^+T细胞阳性率及NK细胞阳性率均显著高于观察组(均P<0.05),CD8+T细胞阳性率及CD64指数均显著低于观察组(均P<0.05)。结论使用免疫抑制剂、红斑狼疮涉及脏器≥2个、SLEDAI评分>9分、低蛋白血症是系统性红斑狼疮合并带状疱疹患者发生医院感染的独立危险因素,监测淋巴细胞亚群和CD64指数有利于评估患者预后。Objective To summarize the clinical features of nosocomial infection in patients with systemic lupus erythematosus combined with herpes zoster,analyze the impact of lymphocyte subsets and CD64 index on the prognosis of nosocomial infections in patients.Method A total of 90 patients with systemic lupus erythematosus combined with herpes zoster treated in Dazhou Integrated TCM&Western Medicine Hospital from January 2017 to December 2017 were selected as study objects.The clinical data of the patients were retrospectively analyzed and the clinical features of nosocomial infections were analyzed.Infected patients were divided into control group and observation group according to their severity of infection.The difference in lymphocyte subsets and CD64 index between the two groups were analyzed.The influence of these differences on the prognosis of patients was analyzed.Result The main sites of infection in patients were respiratory tract and skin.The use of immunosuppressive agents,lupus involving organs(≥2),high SLEDAI score(>9)and hypoproteinemia were independent risk factors for nosocomial infection(all P<0.05).The positive rates of CD3+,CD4+cells and NK cells in control group were significantly higher than those in observation group(all P<0.05),while the positive rates of CD8+cells and CD64 index were significantly lower than those in the observation group(all P<0.05).Conclusion The use of immunosuppressive agents,lupus-related organ involvement(≥2),high SLEDAI score(>9),and hypoproteinemia disease are independent risk factors for nosocomial infection in patients with systemic lupus erythematosus comlicated with herpes zoster.The monitoring of population and CD64 index is helpful to assess the prognosis of patients.

关 键 词：系统性红斑狼疮 医院感染 淋巴细胞亚群 预后 

分 类 号：R593.241[医药卫生—内科学] R752.12[医药卫生—临床医学]