系统性红斑狼疮患者深部真菌感染危险因素及生物学指标研究进展  

Research progress on risk factors and biological indicators of deep fungal infection in patients with systemic lupus erythematosus

作　　者：邹国强 刘英[2] 王旭凤 ZOU Guoqiang;LIU Ying;WANG Xufeng(The First Clinical School of Shandong University of Traditional Chinese Medicine,Jinan 250000,China;Department of Rheumatology and Immunology,Affiliated Hospital of Shandong University of Traditional Chinese Medicine)

机构地区：[1]山东中医药大学第一临床医学院,山东济南250000 [2]山东中医药大学附属医院风湿免疫科

出　　处：《中国病原生物学杂志》2024年第12期1516-1520,共5页Journal of Pathogen Biology

基　　金：山东省自然科学基金面上项目(No.ZR2023MH332)。

摘　　要：系统性红斑狼疮(SLE)是一种自身免疫性疾病,由于SLE患者的免疫功能降低使得患者易合并深部真菌感染(IFI),病情严重时可危及患者性命。本文结合国内外研究文献,旨在综述SLE患者IFI感染的相关危险因素及生物学指标的研究进展。综述梳理几十篇文献后显示,SLE合并IFI发病率、病死率均较高,诱发本病危险因素与糖皮质激素应用、SLE疾病活动指数(SLEDAI)、年龄、性别与HIV感染等密切相关。同时在SLE合并IFI生物学指标方面,本综述结果显示,念珠菌、曲霉菌、隐球菌是IFI发生的主要致病菌,可作为SLE合并IFI检测的生物学指标,为诊断IFI提供依据,而用于检测致病菌的方法良多,优势明显,但均存在一定的局限性。另外,1,3-β-D-葡萄糖测定(BDG)可能是真菌有效检测方法,T淋巴细胞亚群SLE合并感染患者中可能处于异常降低状态,故其可作为辅助诊断IFI的特异性生物学指标。对上述内容进行梳理能帮助临床更深入地了解SLE合并IFI的致病机制,为临床尽早诊断指标提供科学依据。Systemic lupus erythematosus(SLE)is an autoimmune disease.Due to the decreased immune function of SLE patients,patients are prone to complicated with deep fungal infection(IFI),which may endanger their lives in severe cases.Based on the research literature at home and abroad,this paper aims to summarize the research progress of related risk factors and biological indexes of IFI infection in SLE patients.After reviewing dozens of literatures,it shows that the incidence and mortality of SLE complicated with IFI are high,and the risk factors of SLE are closely related to glucocorticoid application,SLE disease activity index(SLEDAI),age,sex and HIV infection.At the same time,in the aspect of biological indicators of SLE complicated with IFI,the results of this review show that Candida,Aspergillus and Cryptococcus are the main pathogens of IFI,which can be used as biological indicators for the detection of SLE complicated with IFI and provide a basis for the diagnosis of IFI.There are many methods for detecting pathogenic bacteria,which have obvious advantages,but they all have certain limitations.In addition,the determination of 1,3-β-D glucose(BDG)may be an effective method to detect fungi,and the T lymphocyte subsets in SLE patients with infection may be abnormally reduced,so it can be used as a specific biological index to assist in the diagnosis of IFI.Sorting out the above contents can help the clinic to understand the pathogenic mechanism of SLE complicated with IFI more deeply and provide scientific basis for early clinical diagnosis.

关 键 词：系统性红斑狼疮 真菌感染 危险因素 生物学指标 研究进展 综述 

分 类 号：R593.241[医药卫生—内科学] R519[医药卫生—临床医学]