系统性红斑狼疮患者合并感染的临床特点及治疗观察

Observation on clinical characteristics and treatment of infection in patients with systemic lupus erythematosus

目的分析系统性红斑狼疮患者合并感染的临床特点及治疗。方法选取120例系统性红斑狼疮患者,对所有患者的临床资料进行回顾性研究,包括病史、临床症状、实验室检查结果、标本检查结果等;根据诊断结果将合并感染的系统性红斑狼疮患者设置为感染组,未合并感染的患者设置为未感染组,比较两组患者的死亡率、住院时间、治疗费用、血沉、C反应蛋白。结果 120例患者中, 33例合并感染(感染组), 87例未合并感染(未感染组),感染发生率为27.5%;感染部位涉及到全身:16例(48.48%)发生在呼吸系统, 10例(30.30%)发生在泌尿系统, 5例(15.15%)发生在泌尿系统,2例(6.06%)发生在其他部分。引起感染的微生物包括细菌和真菌, 27例患者发生细菌感染,致病菌包括金黄色葡萄球菌、肺炎链球菌、铜绿假单胞菌、肺炎克雷伯氏菌、大肠埃希菌、沙门菌;6例患者发生真菌感染,致病菌包括酵母菌、白色念珠菌、曲霉菌。感染组患者的住院时间(17.46±3.25)d、治疗费用(9012.35±1127.37)元均高于未感染组的(12.37±2.46)d、(5938.48±1038.21)元,差异具有统计学意义(P<0.05)。感染组死亡率9.09%高于未感染组的5.75%,但差异无统计学意义(P>0.05)。治疗前,感染组的C反应蛋白和血沉水平均高于未感染组,差异具有统计学意义(P<0.05);治疗后,感染组的C反应蛋白、血沉均明显高于未感染组,差异具有统计学意义(P<0.05)。结论系统性红斑狼疮患者容易并发感染,对于患者的预后和转归有不利影响,因此,临床上应注意防治系统性红斑狼疮患者并发感染。

Objective To analyze the clinical characteristics and treatment of infection in patients with systemic lupus erythematosus.Methods A total of 120 patients with systemic lupus erythematosus were selected,and the clinical data of all patients were retrospectively studied,including medical history,clinical symptoms,laboratory test results,and specimen examination results.According to the diagnostic result,systemic lupus erythematosus patients with infection were set as the infection group,and patients with no infection were set as the uninfected group.Comparison were made on mortality rate,hospitalization time,cost of treatment,erythrocyte sedimentation rate and C-reactive protein between the two groups.Results Among 120 patients,33 cases were complicated with infection(infection group),and 87 cases were not complicated with infection(non-infection group).The incidence of combined infection was 27.5%.The infection sites involved the whole body:16 cases(48.48%)occurred in the respiratory system,10 cases(30.30%)in the urinary system,5 cases(15.15%)in the urinary system,and 2 cases(6.06%)in other parts.The microorganisms causing the infection included bacteria and fungi,27 patients had bacterial infection,including Staphylococcus aureus,Streptococcus pneumoniae,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Salmonella;6 patients had fungal infection,including Yeast,Candida albicans and Aspergillus.Infection group had higher hospitalization time as(17.46±3.25)d and cost of treatment as(9012.35±1127.37)yuan than(12.37±2.46)d and(5938.48±1038.21)yuan in noninfection group,and their difference was statistically significant(P<0.05).Infection group had higher mortality rate as 9.09%than 5.75%in non-infection group,but the difference was not statistically significant(P >0.05).Before treatment,infection group had higher C-reactive protein and erythrocyte sedimentation rate than non-infection group,and the difference was statistically significant(P<0.05).After treatment,the infection group had obviously higher C-reactive protein and erythrocyte sedimentation rate than non-infection group,and the difference was statistically significant(P<0.05).Conclusion Patients with systemic lupus erythematosus are prone to concurrent infection,which has an adverse effect on the prognosis and outcome of the patient.Therefore,clinical attention should be paid to the prevention and treatment of infection in patients with systemic lupus erythematosus.