系统性红斑狼疮患者合并感染临床特点分析

Infection in systemic lupus erythematosus: A clinical characteristic analysis

目的:了解系统性红斑狼疮(SLE)患者合并感染的临床特点及危险因素。方法:收集并随访156例SLE患者临床和实验室资料,按有无合并感染分为感染组与非感染组。结果:156例SLE患者,55例患者(35.26%)发生76次感染(48.72%),其中18例患者发生≥2次感染,呼吸系统及泌尿系统为最常见的感染部位,主要病原菌是革兰阴性杆菌。感染组与非感染组比较:白细胞、24h尿蛋白水平、补体(C3)、系统性红斑狼疮疾病活动度评分(SLEDAI)、抗双链DNA定量(anti-dsDNA)、SLE合并多系统损害、2周前应用广谱抗生素、应用免疫抑制剂≥2种、环磷酰胺(CTX)累计量和激素(PDN)日剂量,差异有统计学意义。多因素Logistic逐步回归分析显示:C3、24h尿蛋白定量、2周前应用抗生素、CTX累计量和激素日剂量是SLE患者并发感染的独立影响因素。结论:SLE并发感染主要为呼吸系统感染。C3、24h尿蛋白定量、2周前应用抗生素、CTX累计量和平均激素日剂量是引起SLE患者感染的独立影响因素。

Objective： To understand the clinical features and risk factors of infection in systemic lupus erythematosus （SLE）. Methods：156 SLE cases of clinic service and hospitalization were collected and divided into infection group and noninfection group.The data were analyzed. Results： Of 156 cases,there were 55 infectant cases （35.26%） and 76 episodes of infections （48.72%）,18 cases with two episodes of infections.Pulmonary and urinary tract were the main infection site.The main pathogen was gram-negative bacillus.There were significant differences in the level of leukocyte,complement 3 （C3）, SLEDAI,antidsDNA,24 h urine protein,and multisystem damage of SLE,the application of broad-spectrum antibiotics previous 2 weeks,immunosuppressive agents used ≥2 species,CTX cumulative and daily prednisone dose between infected SLE patients and control ones. Multivariate regressions showed C 3,24 h urine protein,the application of broad-spectrum antibiotics previous 2 weeks,CTX cumulative and daily prednisone close were independent factors for infection in patients with SLE. Conclusion： Pulmonary is the main infection site.C3, 24 h urine protein,the application of broad-spectrum antibiotics previous 2 weeks,CTX cumulative and daily prednisone dose are independent factors for infection of SLE.