中华风湿病学杂志
中華風濕病學雜誌
중화풍습병학잡지
CHINESE JOURNAL OF RHEUMATOLOGY
2009年
6期
390-393
,共4页
红斑狼疮,系统性%感染%危险因素
紅斑狼瘡,繫統性%感染%危險因素
홍반랑창,계통성%감염%위험인소
Lupus erythematosus,systemic%Infection%Risk factor
目的 了解系统性红斑狼疮(SEE)住院患者的感染情况,探讨SLE患者感染发生的相关危险因素.方法 对2002年5月至2007年7月华山医院SLE住院患者的感染发生情况进行回顾性研究,包括感染部位及感染病原体;对病原菌的耐药情况进行分析;选择SLE患者感染的可疑危险因素,进行单因素分析和Logistic多因素分析.结果 533例SLE患者中发生感染130例,感染发生率为24.4%.1例患者因呼吸道感染死亡.SLE患者常见的感染部位依次为呼吸道(56.9%)、尿道(23.8%)及皮肤软组织(18.5%).在感染病原体构成中,细菌最常见(53.3%),以革兰阴性菌为主,其次为真菌(39.2%),两者合并感染比例高.尚有7例结核患者和10例带状疱疹患者.SLE患者感染最常见菌株为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌及白色念珠菌.细菌药敏试验结果显示耐药菌株比例较高.革兰阴性菌对头孢哌酮,舒巴坦及碳青霉烯类的敏感率较高.感染相关危险因素分析提示老年、低白蛋白血症、中度贫血及大剂量激素治疗为SLE患者感染发生的独立危险因素.结论 呼吸道及尿道为SLE患者最常见的感染部位,病原菌以革兰阴性菌多见,可选用头孢哌酮/舒巴坦或碳青霉烯类药物作为经验性抗菌治疗.
目的 瞭解繫統性紅斑狼瘡(SEE)住院患者的感染情況,探討SLE患者感染髮生的相關危險因素.方法 對2002年5月至2007年7月華山醫院SLE住院患者的感染髮生情況進行迴顧性研究,包括感染部位及感染病原體;對病原菌的耐藥情況進行分析;選擇SLE患者感染的可疑危險因素,進行單因素分析和Logistic多因素分析.結果 533例SLE患者中髮生感染130例,感染髮生率為24.4%.1例患者因呼吸道感染死亡.SLE患者常見的感染部位依次為呼吸道(56.9%)、尿道(23.8%)及皮膚軟組織(18.5%).在感染病原體構成中,細菌最常見(53.3%),以革蘭陰性菌為主,其次為真菌(39.2%),兩者閤併感染比例高.尚有7例結覈患者和10例帶狀皰疹患者.SLE患者感染最常見菌株為大腸埃希菌、肺炎剋雷伯菌、銅綠假單胞菌、金黃色葡萄毬菌及白色唸珠菌.細菌藥敏試驗結果顯示耐藥菌株比例較高.革蘭陰性菌對頭孢哌酮,舒巴坦及碳青黴烯類的敏感率較高.感染相關危險因素分析提示老年、低白蛋白血癥、中度貧血及大劑量激素治療為SLE患者感染髮生的獨立危險因素.結論 呼吸道及尿道為SLE患者最常見的感染部位,病原菌以革蘭陰性菌多見,可選用頭孢哌酮/舒巴坦或碳青黴烯類藥物作為經驗性抗菌治療.
목적 료해계통성홍반랑창(SEE)주원환자적감염정황,탐토SLE환자감염발생적상관위험인소.방법 대2002년5월지2007년7월화산의원SLE주원환자적감염발생정황진행회고성연구,포괄감염부위급감염병원체;대병원균적내약정황진행분석;선택SLE환자감염적가의위험인소,진행단인소분석화Logistic다인소분석.결과 533례SLE환자중발생감염130례,감염발생솔위24.4%.1례환자인호흡도감염사망.SLE환자상견적감염부위의차위호흡도(56.9%)、뇨도(23.8%)급피부연조직(18.5%).재감염병원체구성중,세균최상견(53.3%),이혁란음성균위주,기차위진균(39.2%),량자합병감염비례고.상유7례결핵환자화10례대상포진환자.SLE환자감염최상견균주위대장애희균、폐염극뢰백균、동록가단포균、금황색포도구균급백색념주균.세균약민시험결과현시내약균주비례교고.혁란음성균대두포고동,서파탄급탄청매희류적민감솔교고.감염상관위험인소분석제시노년、저백단백혈증、중도빈혈급대제량격소치료위SLE환자감염발생적독립위험인소.결론 호흡도급뇨도위SLE환자최상견적감염부위,병원균이혁란음성균다견,가선용두포고동/서파탄혹탄청매희류약물작위경험성항균치료.
Objective To investigate infectious complications and analyze their risk factors in patients with systemic lupus erythematosus (SLE) and provide clue for antibiotics treatment. Methods Patients with SLE admitted to our hospital between 2002 and 2007 were. reviewed, and the characteristics of their infections including the infection sites, pathogens and the drug resistance of pathogenic bacteria were investigated. The suspected risk factors of infections in patients with SLE were selectod and then analyzed by chi-square test and Logistic regression. Results The prevalence of infection in this group of patients was 24.4% (130/533). One patient died from respiratory tract infection. The common infection sites were respiratory tract (56.9%), urinary tract (23.8%) and skin (18.5%). Bacteria were the most common pathogens of infections in SLId pa-tients (53.3%), the majority of which were gram-negative bacteria. The second major pathogen was fungus (39.2%), and the third was the combination of bacteria and fungus. There were 7 patients with tuberculosis. The common strains causing infections in SLE patients were. Escheriehia coli, Klebsiella pneumonea, Pseu-domonas aeruginosa, Staphylococcus aureus and Candida albican. Antimicrobial susceptibility tests showod that the drug resistant rates increased rapidly. The gram-negative ones were sensitive to eefoperazone-sulbac-tam and carbopenems. The infection-related risk analysis suggested that the independent risk factors of infections in SLE patients included old age, hypopruteinemia, moderate anemia and high dose of eorticos-teruids treat-ment. Conclusion Those patients with infection-related risk factors should be monitored closely for infec-tions. Respiratory tract and urinary tract are the most common infectious sites in SLId patients, and gram-nega-tive bacteria are the major pathogens, so antibiotics such aa cefoperazone-sulbactam or carbopenems may be good choices before the result of antimicrobial susceptibility test information is available.
