摘要
研究分析狼疮性肾炎 (L N)并发医院感染的临床特点及与临床、病理的关系。方法 收集我科住院治疗的 L N10 9例 ,进行医院感染因素分析。结果 L N医院感染部位常见于下呼吸道、泌尿道、皮肤软组织和消化道 ,分离菌株以革兰阴性杆菌和真菌为主 ;L N医院感染率为 6 0 .6 % ,病情恶化的 13例中 12例并发感染 ,其中6例直接死于严重感染 ;L N临床活动、病理类型呈 、 型者医院感染率较高 ,尿蛋白、血白蛋白和肾功能与医院感染显著相关 (P<0 .0 1) ;L N激素应用时间、住院时间亦与医院感染显著相关 (P<0 .0 1) ;激素合并免疫抑制剂治疗 ,感染率较单用激素明显增高 (P<0 .0 1) ,而常规量激素联合环磷酰胺间歇冲击治疗 ,较大剂量激素联合环磷酰胺冲击治疗 ,医院感染率明显下降 (P<0 .0 5 )。结论 L N医院感染率高达 6 0 .6 % ,这与狼疮临床、病理活动 ,长期大量应用激素和免疫抑制剂及长期住院密切相关。
OBJECTIVE To investigate nosocomial infection in 109 cases with lupus nephritis.METHODS The location of infection,the strains of bacteria,the relationship between infection and prognosis,clinical and pathological types,lupus activity indexes, date in hospital and varied therapies were analyzed.RESULTS Nosocomial infections occurred mainly in the lower respiratory tract,urinary tract, skin, soft tissues and digestive tract. G negative bacilli and fungi were the dominant bacteria in the infections.Twelve of the 13 deteriorated cases complicated with infections,in which 6 died of severe infections.The nosocomial infection showed close relationship with lupus activity indexes,pathological types, date in hospital and varied treatment regimens.Corticosteroid together with immunosuppressive agents induced significant higher infection rate than corticosteroid alone(P<0.01).However,high dose intravenous pulse cyclophosphamide therapy combined with routine prednisone brought about significant lower infection rate than both cyclophosphamide and corticosteroid high dose pulse therapy(P<0.05).CONCLUSIONS Nosocomial infection rate in lupus nephritis was as high as 60.6%.This may be associated with lupus activity,long-term usage of high dose corticosteroid and immunosuppressive agents and long stay in hospital.
出处
《中华医院感染学杂志》
CAS
CSCD
2000年第3期174-176,共3页
Chinese Journal of Nosocomiology
