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目的 了解系统性红斑狼疮 (SLE)患者医院尿路感染情况 ,探讨SLE患者医院尿路感染的相关危险因素。方法 回顾性分析 1997年元月至 2 0 0 2年 12月在我科住院的 332例SLE患者 ,选取其中出现尿路感染的病例 ,分别记录相关资料。结果 SLE患者发生医院尿路感染共 2 9例 (8 73% ) ,感染菌以革兰氏阴性菌为主 (76 6 7% )。强的松用量≥ 15mg组尿路感染发生率明显高于激素用量 <15mg组 (30 15 %vs 13 2 6 % ,P <0 0 1) ,合并应用免疫抑制剂患者尿路感染发生率明显高于单用激素组 (2 6 2 7%vs 9 4 6 % ,P <0 0 1)。留置导尿管患者尿路感染的发生率明显升高。另外 ,住院时间越长 ,疾病活动指数越高 ,越易发生尿路感染。尿路感染组C反应蛋白 (CRP)水平明显高于未感染组 (P <0 0 1)。结论 尿路感染是SLE患者医院感染的常见形式之一 ,SLE患者医院尿路感染的相关危险因素为性别、住院天数、激素及免疫抑制剂的应用、是否留置导尿管、疾病是否活动等。CRP是区分SLE是否发生尿路感染的一个有用指标。
Objective To understand the prevalence of urinary tract infection in hospitalized patients with systemic lupus erythematosus (SLE) and to explore the related risk factors of hospital urinary tract infection in patients with SLE. Methods A retrospective analysis of 332 patients with SLE who were hospitalized in our department from January 1997 to December 2002 was conducted. The cases of urinary tract infection were selected and relevant data were recorded respectively. Results There were 29 hospital urinary tract infections (8 73%) in hospitalized patients with SLE and gram-negative bacteria (76 6 7%). The incidence of urinary tract infection was significantly higher in prednisone ≥ 15mg group than that in hormone group <15mg (30 15% vs 132.6%, P <0.01). The incidence of urinary tract infection was significantly higher in patients with combination of immunosuppressants In the hormone alone group (2627% vs 94.6%, P <0.01). The incidence of urinary tract infection in patients with indwelling catheters was significantly higher. In addition, the longer hospital stay, the higher the disease activity index, the more prone to urinary tract infection. Urinary tract infection group C-reactive protein (CRP) levels were significantly higher than the non-infected group (P <0 01). Conclusions Urinary tract infection is one of the common forms of nosocomial infection in SLE patients. The related risk factors of urinary tract infection in hospital are SLE patients, sex days, days of hospitalization, application of hormones and immunosuppressive agents, catheterization, and whether the disease is active. CRP is a useful indicator of whether urinary tract infection occurs in SLE.