论文部分内容阅读
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%);维持期感染部位主要为泌尿系统(35.6%)、皮肤软组织(30.7%)和肺(16.8%)。(5)诱导期病毒(50.8%vs25.7%,P<0.01)和真菌(6.5%vs1%,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%vs68.3%,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。
Objective: To analyze the clinical features and epidemiological characteristics of infection during the treatment of lupus nephritis (LN). Methods: A retrospective analysis of 699 cases of Ⅱ, Ⅲ, Ⅳ, Ⅴ, Ⅳ + Ⅴ and Ⅴ + Ⅲ type of LN infection in the course of the incidence of the disease, the occurrence of parts and pathogens species characteristics. Results: (1) 699 LN patients, including 92 males and 607 females, with an average age of 28.4 ± 11.1 years, with an average follow-up of 46 months. A total of 225 infections occurred in 191 patients (27.3%), of which 30 were secondary and two were 3. (2) Of the 225 infections, 124 (55.1%) occurred in the induction period, 2.6 ± 1.6 months in duration, and 101 (44.9%) occurred in the maintenance phase and occurred in 24.3 ± 16.6 months. (3) Infected parts were mainly skin and soft tissues, lung and urinary system (89.3%). Bacteria were the most common pathogens (54.2%), followed by virus (39.6%) and deep fungi (4%). (4) The main inducing sites of infection were mainly skin and soft tissue (50.8%), lung (32.3%) and urinary system (11.3%). Urinary system (35.6%), skin and soft tissue (16.8%). (5) The infection rate of inducible virus (50.8% vs 25.7%, P <0.01) and fungi (6.5% vs1%, P <0.01) was higher than that of maintenance phase, while the proportion of bacterial infection was lower than that of maintenance phase (42.7% vs68.6% 3%, P <0.01). CONCLUSIONS: The overall incidence of LN complicated by infection is 27.3%. The most common infection occurs within 3 months after induction therapy. There are differences between the infection sites and the types of pathogens in induction and maintenance phases.