关键词: 狼疮性肾炎, 侵袭性肺曲霉病, 真菌感染, 预后

Abstract: Ｏｂｊｅｃｔｉｖｅ：To retrospectively analyse the clinical characteristics and prognosis of invasive pulmonary aspergillosis (IPA) in patients with lupus nephritis (LN) during treatment.
Ｍｅｔｈｏｄｏｌｏｇｙ：This study included clinical data and prognosis of 22 LN patients combined with IPA who were admitted to the National Clinical Medical Research Center for Kidney Diseases between September 2008 and January 2022.
Ｒｅｓｕｌｔｓ：Among 22 patients with IPA, the age of LN onset was 35.6±15.6 years, and the duration of LN was 4.5 (3,51) months. Prior to the diagnosis of IPA, the patients had received an average of three immunosuppressive drugs in the six months leading up to it. The most common initial symptoms were fever, cough and sputum (72.7％), aspergillus fumigatus was the most prevalent. 7 (31.8％) patients died within 3 months of IPA, the death group had significantly higher levels of 24-hour proteinuria before IPA, blood lactate dehydrogenase and systemic lupus erythematosus disease activity index (SLEDAI) at the time of infection compared to the survival group (P<0.05). Additionally, the death group had significantly lower counts of CD20+B-lymphocyte cells (P<0.05). The study found that combined mixed infections, admission to the intensive care unit, the use of immunoglobulin or leukogenic drugs, endotracheal intubation and continuous renal replacement therapy (CRRT) during treatment were significantly more common in the deceased group than in the surviving group (P<0.05). Five patients entered end-stage kidney disease (ESKD) during follow-up.
Ｃｏｎｃｌｕｓｉｏｎ：The risk factors for IPA in LN patients were complex, and patients with active lupus and compromised immunologic function have poorer outcome.

Key words: lupus nephritis, invasive pulmonary aspergillosis, fungal infections, prognosis