狼疮性肾炎患者并发感染的特点与预防

Infectious Complications in Patients with Lupus Nephritis

目的 :观察并分析狼疮性肾炎 (LN)患者的感染发生情况 ,探讨在临床上对这一人群的治疗和随访是否具有借鉴意义。方法 :对 15 3例LN患者从入院起即观察该人群的感染发生率、感染好发部位、病原体特点以及应用糖皮质激素、免疫抑制剂治疗情况。结果 :15 3例LN患者中 5 0例 (32 .7% ) 77人次出现感染并发症。感染好发部位依次为下呼吸道、泌尿道、皮肤等。病原体以细菌最多见 (4 6人次 ,5 9.7% ) ,包括金黄色葡萄球菌等 ,其次为真菌(18人次 ,2 3.4 % )。 15 3例LN患者均接受不同剂量的肾上腺糖皮质激素治疗 ,5 0例发生感染的患者中 39例同时应用环磷酰胺或其他免疫抑制剂治疗。结论 :LN患者是感染高发人群 ,下呼吸道是感染最好发部位。临床上应严格掌握上述药物的应用指征和剂量 ,避免不必要的抗菌素使用 ,同时对患者进行健康宣教 。

Objective:To investigate infectious complications in patients with lupus nephritis (LN).Methods:153 patients with LN were followed up from their admission. The prevalence of infection, the common infection sites, pathogens and dosages of corticosteroids and/or immunosuppressives were analysed.Results:Fifty out of 153 patients with LN(32.7%) had 77 infection episodes. The common affected sites were lower-respiratory tract,urinary tract and skin. The majority were bacterial, but viral and fungal were also identified. All patients were receiving corticosteroids on different dosages. Thirty nine out of 50 patients at time of infection were treated with CTX or other immunosuppressers.Conclusion:Infectious complications are often seen in patients with LN and the lower-respitory tract is the commonest affected site. It seems that strictly controlling the indication and dosage of corticosteroids and/or immunosuppressers in patients with LN,avoiding unnecessary antibiotics and sanitary education might reduce the prevalence of infectious complicatons in this porpulation.