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肾脏病与透析肾移植杂志 ›› 2012, Vol. 21 ›› Issue (3): 232-236.

• 论文 • 上一篇    下一篇

狼疮性肾炎患者并发感染的临床分析

  

  • 出版日期:2012-06-28 发布日期:2012-06-25

Clinical Features of Infection in patients with Lupus Nephritis

  • Online:2012-06-28 Published:2012-06-25

摘要:

摘  要  目的:分析狼疮性肾炎(LN)治疗过程中感染的临床和流行病学特征。方法:回顾性分析699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: (1)699例LN患者,其中男92例,女607例,平均年龄28.4±11.1岁,平均随访46月。191例(27.3%)患者共发生225例次感染,其中30例2次感染,2例3次感染。(2)225例次感染中,124例次(55.1%)发生在诱导期,发生时间2.6±1.6月,101例次(44.9%)发生在维持期,发生时间24.3±16.6月。(3)感染部位以皮肤软组织、肺、泌尿系统为主(89.3%);感染病原体以细菌最常见(54.2%),其次为病毒(39.6%)和深部真菌(4%)感染。(4)诱导期感染部位主要为皮肤软组织(50.8%)、肺(32.3%)和泌尿系统(11.3%);维持期为泌尿系统(35.6%)、皮肤软组织(30.7%)和肺(16.8%)。(5)诱导期病毒(50.8% vs 25.7%,P<0.01)和真菌(6.5% vs 1%,P<0.01)感染比例高于维持期,而细菌感染比例低于维持期(42.7% vs 68.3%,P<0.01)。结论: LN并发感染的总体发生率为27.3%,感染最常发生于诱导治疗3月内,诱导期与维持期感染部位及病原体种类均存在差异。

关键词: 狼疮性肾炎 , 感染 , 发生率

Abstract:

ABSTRACT  Objective: To investigate the clinical and epidemiologic features of infection in patients with lupus nephritis (LN). Methodology: Six hundred and ninety-nine LN patients were enrolled in this study. They were 607 female,92 male with a mean age  of 28.4±11.1 years old. All of them were performed renal biopsy, and their histological patterns were Class Ⅱ、Ⅲ、Ⅳ、Ⅴ、Ⅳ+Ⅴ or Ⅴ+Ⅲ type. The infection incidence,infectious phase, sites and infective pathogens in different phases were analyzed retrospectively. Results:(1)There were 191 cases 27.3%)of 699 LN patients with infection complication, the total duration of follow-up was 46 months. 191 patients had 225 infection episodes,30 cases with two episodes of infection, and 2 cases with three episodes of infection.(2)Of 225 infection episodes , 124(55.1%)episodes occurred in the phase of induction therapy after a follow-up period of (2.6±1.6) months. 101(44.9%)episodes happened in the phase of maintenance therapy , and time of occurrence were(24.3±16.6)months. (3)The most common affected sites were skin、lung and urinary tract system(89.3%). The most common pathogens were bacteria (54.2%), followed by virus (39.6%) and deep fungus (4%), respectively.(4)In the phase of induction therapy, the most common affected sites were skin(50.8%), lung(32.3%) and urinary tract system(11.3%), respectively. However, in the maintenance phase, the infection sites were urinary system(35.6%)、skin(30.7%) and lung(16.8%), respectively. (5)The induction and maintenance phase, the most pathogens were bacteria(42.7% vs  68.3%, P<0.01)、virus(50.8% vs 25.7%, P<0.01)、fungi(6.5% vs 1%, P<0.01).  Conclusions: The incidence of infection in patients with LN was 27.3%, and usually occurred within the 3 months. There were significant differences in affected sites and pathogens during the phase of induction and maintenance therapy.

Key words: Lupus nephritis, , Infections, , Clinical feature