系统性红斑狼疮患者医院尿路感染分析

Analysis of nosocomial urinary tract infection in patients with systemic lupus erythematosus

目的 了解系统性红斑狼疮 (SLE)患者医院尿路感染情况 ,探讨SLE患者医院尿路感染的相关危险因素。方法 回顾性分析 1997年元月至 2 0 0 2年 12月在我科住院的 332例SLE患者 ,选取其中出现尿路感染的病例 ,分别记录相关资料。结果 SLE患者发生医院尿路感染共 2 9例 (8 73% ) ,感染菌以革兰氏阴性菌为主 (76 6 7% )。强的松用量≥ 15mg组尿路感染发生率明显高于激素用量 <15mg组 (30 15 %vs 13 2 6 % ,P <0 0 1) ,合并应用免疫抑制剂患者尿路感染发生率明显高于单用激素组 (2 6 2 7%vs 9 4 6 % ,P <0 0 1)。留置导尿管患者尿路感染的发生率明显升高。另外 ,住院时间越长 ,疾病活动指数越高 ,越易发生尿路感染。尿路感染组C反应蛋白 (CRP)水平明显高于未感染组 (P <0 0 1)。结论 尿路感染是SLE患者医院感染的常见形式之一 ,SLE患者医院尿路感染的相关危险因素为性别、住院天数、激素及免疫抑制剂的应用、是否留置导尿管、疾病是否活动等。CRP是区分SLE是否发生尿路感染的一个有用指标。

Objective To investigate nosocomial urinary tract infection in patients with systemic lupus erythematosus (SLE).Methods A total of 332 in-patients from Jan.1997 to Dec.2002 in our department were investigated retrospectively.Results The nosocomial urinary tract infection rate was 8.73% in patients with SLE.The predominant pathogen of nosocomial urinary tract infection was Gram negative bacilli (76.67%).The occurrence of nosocomial urinary tract infection was associated with gender,nosocomial duration,the dosage of prednisone and the combined administration of immunosuppressive agents,urethral catheter used,and systemic lupus erythematosus disease activity index(SLEDAI).The level of C-reactive protein (CRP) was higher in the patients with urinary tract infection than that in controls (P<0.01).Conclusion Urinary tract infection is one of the common nosocomial infection in patients with SLE.The main risk factors of nosocomial urinary tract infection in patients with SLE are gender,nosocomial duration,the dosage of prednisone and combined administration of immunosuppressive agents,urethral catheter used,and SLEDAI.The level of CRP may help to differentiate nosocomial urinary tract infection from the patients with SLE.