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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。
To study the clinical characteristics of lupus nephritis (LN) complicated with nosocomial infection and its relationship with clinical and pathological features. Methods We collected 9 cases of L N10 hospitalized in our department for analysis of nosocomial infection. Results LN hospital infection sites were common in the lower respiratory tract, urinary tract, skin and soft tissue and digestive tract, isolates of gram-negative bacilli and fungi mainly; LN hospital infection rate was 60.6%, 13 cases of exacerbations in 12 cases Six cases died of severe infection directly. LN clinical activity and pathological type were higher in patients with nosocomial infection, and urinary protein, serum albumin and renal function were significantly associated with nosocomial infection (P <0.01) The application time and hospital stay of LN were also significantly associated with nosocomial infections (P <0.01). The treatment with steroid combined with immunosuppressive drugs had a significantly higher infection rate (P <0.01) Hormone combined with cyclophosphamide intermittent impact treatment, larger doses of hormone combined with cyclophosphamide shock treatment, hospital infection rate was significantly decreased (P <0.05). Conclusion The prevalence of LN in hospital is 60.6%, which is closely related to the clinical and pathological activities of lupus, prolonged use of hormones and immunosuppressive agents and long-term hospitalization.