原发性肾病综合征合并医院感染的临床分析

Clinical Analysis of the Primary Nephrotic Syndrome Complicated by the Hospital Infection

目的:探讨原发性肾病综合征(PNS)合并医院感染的特点及防治措施。方法:对1995～1999年我院治疗的PNS患者进行回顾性涮查。结果:在133例PNS中,感染发生率为24.1％;感染组24h尿蛋白定量、血清肌酐明显高于非感染组(P均<0.01),而血清白蛋白及IgG水平则明显低于非感染组(P均<0.01);感染组较非感染组的住院时间长(P<0.01);联合应用激素及细胞毒药物较单用激素的感染发生率高(P<0.05);应用血浆较未用血浆的感染发生率低(P<0.05)。结论:PNS合并医院感染主要与大量蛋白尿、低蛋白血症、血清IgG水平低下、肾功能不全及应用免疫抑制剂有关;积极治疗原发病、改善肾功能、缩短住院时间及应用血浆,可望降低其感染发生率。

Objective To explore the characteristics of the primary nephrotic synarome (PNS) complicated by hospital infection and measures to prevent and treat it. Method Data of the patients with PNS hospitalized in our hospital from 1995 to 1999 were analyzed retrospectively. Results The infection rate was 24.1% in 133 cases with PNS. The proteinuria and serum creatinine in the infected group were significantly higher than those in the non - infected group ( P < 0.01). The serum albumin and IgG levels in the infeeted group were significantly lower than those in the non - infected group (P < 0.01). The time when the patients in the infected group had been in the hospital was longer than that in the non - infected gronp (P<0.05) . The infection rate in combined hormone with cytotoxin drugs group was significantly higher than that in only using hormone group ( P < 0.05) . The infection rate in the patients to whom plasme was given via the vein was lower significantly than that in the patients who did not receive plasma (P<0.05). Conclusions PNS complicated by hospital infection was connected mainly with the massive proteinuria, hypoproteinemia, low serum IgC level, renal insufficiency and using immunosuppressants. The infection rate conld be depressed by actively treating the primary disease, improving renal function, reducing the time in hospital and using plasma.