皮肌炎合并感染的特点与危险因素分析

Characteristics of infections in patients with dermatomyositis and analysis of risk factors

目的探讨皮肌炎患者合并感染的特点及相关危险因素。方法回顾性分析107例患者的临床资料和感染情况,并填入自制表格,内容包括性别、年龄、住院时间、患者的感染率、感染部位、基础疾病、病原菌等,并采用流行病学方法进行统计分析。结果皮肌炎患者发生医院感染41例,感染率38.32%,感染部位以呼吸道居多,占41.46%,其次为皮肤粘膜感染,占24.39%,泌尿道占14.63%;检出病原菌38株,检出率为92.69%,其中,革兰阳性菌17株占44.74%,革兰阴性菌13株占34.21%,真菌5株占13.16%;通过对感染的相关因素进行分析,其中年龄、住院时间、低蛋白血症和侵入性操作等是导致皮肌炎患者发生感染的主要因素,差异有统计学意义(P<0.05)。结论皮肌炎患者感染的发生率高,应当针对相关因素采取合理措施,以有效预防其感染的发生,促进患者早日康复。

Objective To investigate the characteristics of infections in patients with dermatomyositis and risk factors. Methods A retrospective analysis was conducted on the medical records and infection situation of 107 patients, including gender, age, length of stay in hospital, the frequency of rate, the site of infection, underlying diseases, and pathogens, etc. , and statistical analysis with epidemiological methodology were carried out. Results The infections occurred in 41 of all the patients with dermatomyositis with the incidence rate of 38.32%, among which there were 41.46% of respiratory tract infections, 24. 39% of skin soft tissue infections and 14. 63% of urinary tract infections. Totally 38 strains of pathogens were isolated with the isolation rate of 92. 69% , including 17 （44.74%） strains of gram-positive bacteria, 13 （34. 21% ） strains of gram-negative bacteria, and 5 （ 13.16% ） strains of fungi. The analysis of the related factors for the infections showed that the age, length of hospital stay, hypoproteinemia and invasive operation were the main factors leading to the infections in the patients with dermatomyositis, with statistical significance （P 〈 0. 05）. Conclusion The incidence rate of infections is so high in the patients with dermatomyositis that it is necessary to take reasonable measures aiming at the related factors so as to prevent the infections and to promote the early recovery.