CAJ | 학술논문

[目的]分析狼疮性肾炎（LN）治疗过程中感染的临床特点和流行病学特征。[方法]回顾性分析129例Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅳ＋Ⅴ及Ⅴ＋Ⅲ型LN患者在治疗过程中感染的发生率、发生时期、部位及病原体种类特点。[结果]129例LN患者，36例（27．9％）患者共发生50例次感染，其中治疗方案以CTX组及MMF组发生率最高，28例次（56．0％）发生在诱导期，发生时间（2．6±1．6）个月；22例次（44．0％）发生在维持期，发生时间（20．3±12．6）个月。感染部位以皮肤软组织、肺、泌尿系统为主（86．0％）；感染病原体以细菌最常见（54．0％），其次为病毒（38．0％）和深部真菌（8％）感染。诱导期感染部位为皮肤软组织（50．0％）、肺（32．1％）和泌尿系统（10．7％）；维持期感染部位主要为泌尿系统（36．4％）、皮肤软组织（27．3％）和肺（13．6％）。诱导期病毒（46．2％vs27．3％，P＜0．01）和真菌（10．9％vs4．5％，P＜0．01）感染比例高于维持期，而细菌感染比例低于维持期（42．9％vs68．2％，P＜0．01）。[结论]LN并发感染的总体发生率为27．9％，感染最常发生于诱导治疗3月个内，诱导期与感染期部位及病原体种类均存在差异。
[목적]분석랑창성신염（LN）치료과정중감염적림상특점화류행병학특정。[방법]회고성분석129례Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅳ＋Ⅴ급Ⅴ＋Ⅲ형LN환자재치료과정중감염적발생솔、발생시기、부위급병원체충류특점。[결과]129례LN환자，36례（27．9％）환자공발생50례차감염，기중치료방안이CTX조급MMF조발생솔최고，28례차（56．0％）발생재유도기，발생시간（2．6±1．6）개월；22례차（44．0％）발생재유지기，발생시간（20．3±12．6）개월。감염부위이피부연조직、폐、비뇨계통위주（86．0％）；감염병원체이세균최상견（54．0％），기차위병독（38．0％）화심부진균（8％）감염。유도기감염부위위피부연조직（50．0％）、폐（32．1％）화비뇨계통（10．7％）；유지기감염부위주요위비뇨계통（36．4％）、피부연조직（27．3％）화폐（13．6％）。유도기병독（46．2％vs27．3％，P＜0．01）화진균（10．9％vs4．5％，P＜0．01）감염비례고우유지기，이세균감염비례저우유지기（42．9％vs68．2％，P＜0．01）。[결론]LN병발감염적총체발생솔위27．9％，감염최상발생우유도치료3월개내，유도기여감염기부위급병원체충류균존재차이。
[Objective]To analyze the clinical and epidemiologic features of infection in patients with lupus nephritis(LN) .[Methods] The incidence rate ,time ,site and pathogen of infection in 129 LN patients with type Ⅱ ,Ⅲ ,Ⅳ ,Ⅴ ,Ⅳ + Ⅴ and Ⅴ + Ⅲ during the treatment were analyzed retrospectively .[Results] Among 129 LN patients ,36 patients(27 .9% ) had 50 cases of infection .The incidence of infection in CTX group and MMF group was the highest .Twenty two cases(44 .0% ) of infection occurred in maintenance phase ,and the occurrence time was (20 .3 ± 12 .6) months .The most common infection sites were skin ,lung and urinary tract system(86 .0% ) .The most common pathogens were bacteria(54 .0% ) ,followed by virus(38 .0% ) and deep fungus(8% ) ,respectively .In induction phase ,the most common infection sites were skin soft tissue (50 .0% ) ,lung (32 .1% ) and urinary tract system (10 .7% ) .In maintenance phase ,the main infection sites were urinary system(36 .4% ) ,skin soft tissue(27 .3% ) and lung(13 .6% ) .The infection rate of virus and fungi in induction phase were higher than those in maintenance phase(42 .9% vs .68 .2% ,10 .9% vs .4 .5 % , all P <0 .01) ,but the infection rate of bacteria in induction phase was lower than that in maintenance phase (46 .2% vs .27 .3% ,P<0 .01) .[Conclusion] The total incidence of infection in LN patients is 27 .9% .The infection usually occurs within 3 months .There is significant difference in infection site and pathogen between induction phase and maintenance phase .