系统性红斑狼疮患者合并重症感染的危险因素分析

The risk factors of severe infections in systemic lupus erythematosus patients

目的 了解系统性红斑狼疮 (SLE)患者发生重症感染的危险因素。方法 合并重症感染的SLE患者 (88例 ,重症感染组 )和无感染的SLE患者 (70例 ,无感染组 ) ,对两组年龄、病程、免疫抑制剂和激素的使用、受累脏器数、血白细胞以及白蛋白水平进行分析 ,并行SLE DAI评分。结果 (1)重症感染组和无感染组间SLE DAI评分、激素用量、受累脏器数、白细胞减少和血浆白蛋白水平比较差异有显著性 (P <0 .0 5 )。 (2 )SLE病情活动、低白蛋白、血WBC下降、激素冲击和免疫抑制剂使用合并严重感染的相对危险性分别为 4、4.3 7、3 .5 1、2 .74和 0 .87。 (4 )真菌感染与甲基强的松龙冲击相关性最强。结论 SLE患者合并重症感染主要与病情活动性和轻重以及激素用量有关 。

Objective To investigate clinical features and the risk factors of severe infections in systemic lupus erythematosus(SLE)patients.Methods 88 in-patients of SLE with multiple infections in Peking Union Hospital were collected.another 70 SLE patients without infections at the same time were randomly chosen as control group. The differences of patients 'sex,age,disease duration,leukocytopenia,hypoalbulimia,SLE-DAI,immunosuppressor administrations and dosage of corticosteroids were analyzed and compared between two groups.Results There were significantly differences between patients with severe infections group and control group in SLE-DAI,number of organs involved,serum albumin levels,leukocytopenia and dosage of corticosteroids.But no differences between two groups in immunosuppressor administration.The relative risk of activity disease,hypoalbuimia,leucytopenia and methyprednisonal pulse injection and immusuppressor administration for infection were 4,4.37,3.51,2.74 and 0.87,respectively.Fungus infection seems most relative to corticosteroid.Conclusion Severe infection in SLE is related to many factors,such as the disease activity,dosage of corticosteroids.the number of organs involved,serum albumin levels and WBC level,ect.Immunosuppressor seems not increase the risk of infection.