广州市系统性红斑狼疮患者发生感染的影响因素研究

The risk factors of systemic lupus erythematosus( SLE) patients complicated with infections in Guangzhou City

目的 分析系统性红斑狼疮（systemic lupus erythematosus,SLE）患者发生感染的情况,探讨激素及免疫治疗与SLE患者发生感染的关系,为SLE的预防提供科学依据。方法 运用现况研究方法对广州市SLE患者进行研究,经实验室确诊发生细菌、病毒、真菌等感染者为感染组,没发生感染者为对照组。运用EpiData3.02双录入数据,运用SPSS17.0进行统计学分析。结果 222例SLE患者中发生感染76例,感染发生率为34.23%。单因素分析显示住院时间、SLEDAI评分、受累系统数量等方面与SLE患者发生感染有关（均有P〈0.05）。免疫治疗和激素治疗与SLE患者是否发生感染无关（均有P〉0.05）。多因素分析显示SLE患者发生感染的因素为贫血（OR（95%CI）：4.17（1.33～13.16））、病程长（OR（95%CI）：2.35（1.07～5.18））、SLEDAI评分（≥10）（OR（95%CI）：15.88（5.83～43.22））等。激素治疗（〉40mg/d）与SLE患者发生感染的OR（95%CI）为1.07（0.49～2.35）,免疫治疗与SLE患者发生感染的OR（95%CI）为0.96（0.50～1.85）（均有P〉0.05）。结论 激素和免疫抑制治疗与SLE患者发生感染无关。积极控制感染和贫血,减少受累器官的数量是改善SLE患者预后的关键。

Objective To investigate the risk factors of SLE patients with infectious complications, providing measures for the control and prevention of SLE. Methods Cross sectional study was conducted and SLE patients with in- fection were enrolled as the case group, SLE patients without infection were enrolled as the control group. Epi data 3.02 was used for double data entry and SPSS 17.0 was used for the statistic analyses. Results The prevalence of infection in SLE patients was 34. 23% （76/222）. Univariate analysis showed that the days stayed in hospital, SLEDAI, number of in- fection organs were associated with SLE infection （ all P 〈 0, 05 ）. Hormonal therapy and immunotherapy had no relation with SLE infection（ both P 〉 0.05）. Logistic regression showed that the OR and 95% CI of anemia and SLE infection was 4. 17（ 1.33-13. 16）. Moreover, the OR and 95% CI of the duration of disease was 2.35（1.07-5.18） , the score of SLE- DAI over 10 was 15.88（5.83-43.22）compared with those of the control group. The OR and 95% CI of hormonal therapy （over 40rag/d） and SLE infection was 1.07 （0. 49-2. 35 ）. For immunotherapy, the OR and 95% CI was 0. 96 （0. 50- 1.85 ）. Conclusions Hormonal therapy and immunotherapy have no relation with SLE accompanying infection. The preva- lence rate of SLE accompanying infection was high and the infection is one of the main causes of SLE deaths. Comprehen- sive and active control measure of anemia is essential for improving the prognosis in patients with SLE.