狼疮性肾炎患者并发医院感染的临床特点及相关因素分析

Lupus Nephritis Patients with Hospital Infections: Related Factors and Clinical Feature

目的探讨狼疮性肾炎(LN)患者并发医院感染的临床特点及相关因素。方法回顾性分析医院住院治疗的LN患者78例的临床资料,并对44例发生医院感染的临床特点及相关因素进行分析。结果 LN患者医院感染部位最常见于下呼吸道、其次为泌尿道、皮肤软组织和消化道;分离菌株以革兰阴性杆菌和真菌为主;LN医院感染率为56.41%,医院感染率与治疗方案相关,激素合并免疫抑制剂治疗,感染率较单用激素者明显升高(P<0.01),大剂量激素联合环磷酰胺双冲击治疗者较激素或环磷酰胺单冲击治疗,医院感染率明显升高(P<0.05);LN患者激素应用的时间、血清白蛋白水平、住院时间亦与医院感染显著相关(P<0.01或P<0.05)。结论 LN患者医院感染较高,其感染发生主要与长期大剂量应用激素和免疫抑制剂、血清白蛋白水平及住院时间较长密切相关,应引起相关医护人员的高度重视。

OBJECTIVE To discuss the clinical features of hospital infection and the related factors in patients with lupus nephritis（LN）.METHODS The clinical data about treatment of 78 cases with LN in our hospital were retrospectively analyzed,from them 44 cases（56.41%） were with hospital infection and their clinical characteristics and the related factors were analyzed.RESULTS The most common site of infection in patients with LN was in lower respiratory tract,followed by urinary tract,skin and soft tissue and the digestive tract;the isolates were mainly Gram-negative bacilli and fungi.The treatment modality was one of the related factors of infection.The infection rate was higher in hormone combined with immunosuppressant treatment than in hormone alone treatment（P0.01）,and also higher in the double impact large-dose cyclophosphamide with hormone treatment than in the single impact treatment of hormones or cyclophosphamide（P0.05）;The other related factors were the hormone application time,serum albumin level and hospitalization time（P0.01 or P0.05）.CONCLUSIONS The hospital infection is higher among patients with LN,and mainly relates with long-term use of large-dose corticosteroids and immunosuppressants,serum albumin level and hospitalization time,the relevant medical and nursing staff should pay attention to them.