大疱性类天疱疮患者发生感染的分析

Analysis of Infections in Patients with Bullous Pemphigoid

目的分析大疱性类天疱疮(bullous pemphigoid,BP)患者中感染(主要为细菌感染)的发生情况。方法回顾性分析2011年3月-2016年8月期间63例初治住院BP患者的院内感染发生率、出院后感染发生率及其影响因素。结果 63例BP患者中,男26例,女37例,平均年龄72.20±11.12(40～93)岁。病程1.93±2.07(0.10～12)个月。入院时13例患者CD4^+ T淋巴细胞计数<300/μL,诊断为CD4淋巴细胞减少症(CD4 lymphocytopenia,CL),占20.63%。60例应用系统激素治疗,其中45例联合外用激素、14例联合免疫抑制剂。63例BP患者总的感染发生率为33.33%(21/63),21例中5例伴有CL。常见感染为肺炎76.19%、泌尿系感染19.05%、皮肤软组织感染14.29%,其中4例(19.05%)伴菌血症。13例伴有CL的BP患者中5例(38.46%)发生了感染。高龄和卧床是BP患者感染发生率升高的危险因素(P均<0.05)。结论 BP患者中感染发生率较高,CD4淋巴细胞减少症发生率也较高,二者的发生原因、影响因素及相关性值得进一步研究。

Objective To analyze the infections (mainly bacterial infections) in patients with bullous pemphigoid (BP). Methods We retrospectively analyzed the nosocomial infections,post-charge infections in 63 patients with BP who were hospitalized for the first time from March 2011 to August 2016. ResultsAmong the 63 patients,26 were male and 37 were female. The mean age was 72.20±11.12 years (range 40~93). The mean duration was 1.93±2.07 months (range 0.10~12). There was 13 (20.63%) patients whose CD4+ T lymphocyte count less than 300/uL at admission,who were diagnosed with CD4 lymphocytopenia (CL). Systemic corticosteroids were applied in 60 cases,including 45 cases combined with topical corticosteroids and 14 cases combined with immunosuppressants. The total rate of infections in 63 patients was 33.33%(21/63). In the 21 patients,5 had CL. There were 76.19% patients with pneumonia,19.05% with urinary tract infections and 14.29% with skin soft tissue infections. Four patients (19.05%) had bacteremia. Of the 13 BP patients with CL,5 (38.46%) suffered from infections. T-test and chi-square test showed that old age and immobilization were risk factors for the increased incidence of infections in BP patients (P<0.05). ConclusionIn patients with BP,the incidence of infections and CD4 lymphocytopenia was high. But it need to be further investigated.