疮狼性肾炎患者并发院内真菌感染的特点及危险因素分析

Nosocomial fungal infection in patients with lupus nephritis:clinical feature and risk factors

目的分析狼疮性肾炎(LN)患者并发医院内真菌感染的特点及相关危险因素。方法回顾性分析2005年1月至2011年9月我院肾内科狼疮性肾炎156例患者的临床资料及医院感染的情况。选择性别、年龄、住院时间、血清白蛋白(Alb)、血红蛋白(Hb)、治疗方案(一个单纯激素治疗方案及3个联合治疗方案)及真菌感染等指标建立数据库,采用SPSS 17.0行Logistic多因素回归分析。结果 156例狼疮性肾炎患者中发生院内感染73例(46.8%),其中真菌感染为20例(12.8%);患者住院时间为患者院内真菌感染的危险因素(<0.05);相对单纯激素(P)治疗,几种复合治疗方案(激素+霉酚酸酯(+MMF);激素+免疫抑制剂环磷酰胺(+CTX);激素单冲击+环磷酰胺(P单冲击+CTX))为院内真菌感染的危险因素(<0.05),Alb及Hb是其保护因素(<0.05)。结论 LN患者易并发院内真菌感染,减少住院时间,营养状况的改善,以及适当的治疗方案有助于降低住院患者真菌感染的发生。

Objective To investigate the characteristics and risk factors ofnosocomial fungal infection in patients with lupus nephritis （LN）. Methods Data of 156 hospitalized patients with LN （from January 2005 to September 2011 ） was collected and the occurrence ofhospital infection was retrospeetively analyzed. The statistical indexes ineluded sex, age, hospitalizing times, Albumin （Alb）, Hemoglobin （Hb）, and therapeutic schemes （a single plan P and three combined plans： P＋ MMF, P＋CTX and pulse therapy ＋CTX）, database was built by SPSS （version 17.0） and regression analysis was performed using Binary Logistic Regression. Rusults 73 patients （about 46.8%） occurred the different kinds and different degree of hospital-acquired infections in all patients with LN. The fungal infection rate was 12.8% （20/156）. Hospitalizing times, Albumin （Alb） and Hemoglobin （Hb） were the risk factors for fungal infection （P〈0.05）. Compared with the P scheme, three conbined with three combined therapeutic schemes were also risk factors for fungal infection （P〈0.05）. Alb and Hb were the protective factors for fungal infection （P〈0.05）. Conclusion Patients with lupus nephritis were susceptible to nos- ocomialfungalinfections. The incidence rate can be decreased by redueing hospitalizing times, proper nutfitional supporting and therapeutic schemes.