系统性红斑狼疮合并尿路感染的临床分析

目的探讨系统性红斑狼疮（SLE）合并尿路感染的临床特点。方法对金华市中心医院243例SLE患者中合并尿路感染的95例患者（占SLE总数的39．1％）SLE疾病活动指数、白细胞和血小板水平、血清补体（C3、C4）、红细胞沉降率、抗双链DNA及24h尿蛋白等数据、患者临床表现及相关危险因素进行分析。结果SLE合并尿路感染患者各项生理指标均出现异常，67例出现抗双链DNA升高平均值为（67±22）U／m1]，占70．5％；54例出现白细胞减少平均值为（2．7±0．5）×10^9／L]，占56．8％；51例红细胞沉降率增大平均值为（35±18）ram／1h]，占53．7％；47例血小板减少平均值为（81±12）×10^9／L]，占49．5％；42例补体C3减少平均值为（577±213）mg／L]，占44．2％；41例补体C4减少平均值为（89±24）mg／L]，占43．2％；39例24h尿蛋白增加平均值为（4．1±1．0）g]，占41．0％。发生大肠杆菌感染69例，占尿路感染总数的72．6％；混合感染81例，占85．3％。Logistic回归分析结果：Sledal评分、血白细胞和血小板减少均与尿路感染的发生显著相关（OR：3．274，OR=2．454，OR=2．133，P〈0．01或P〈0．05）。结论SLE患者易合并尿路感染，且以复杂性尿路感染为主，大肠杆菌为尿路感染的主要致病菌。

Clinical analysis of systemic lupus erythematosus complicated with urinary tract infection

Objective To make a clinical analysis of systemic lupus erythenmtosus （SLE） complicated with urinary tract infection. Methods The experimental data, including systemic lupus erythematosus disease ac- tivity index （SLEDAI）, white blood cell and platelet levels, serum complement （C3, CA）, blood sedimentation rate, anti-dsDNA and urine protein in 24 h were recorded ; clinical manifestations of 243 patients with SLE and re- lated risk factors were analyzed comprehensively. Results Ratio of the patients with SLE complicated with urinary tract infection in all SLE patients was 39.1%. Sixty-seven cases（70.5% ） showed a increase of anti-dsDNA （67 ± 22 ） U/ml ] ; 54 cases （ 56.8 % ） showed a decrease of WBC （ 2.7 ± 0.5 ） × 109/L ] ; 51 cases （ 53.7 % ） showed a increase of erythrocyte sedimentation rate （35 ＋ 18 ） ram/1 h ] ;47 cases （49.5%） showed a decrease of blood platelet （81 ＋ 12） × 109/L] ; 42 cases（44.2% ） showed a decrease of complement C3 （577±213） mg/L] ;41 cases （43.2%） showed a decrease of complement CA （89 ± 24） mg/L] ; 39 cases（41.0% ）showed an increase of 24 h urine protein （4.1 ± 1.0）g]. Infection induced by Escherichia coli was 69 cases（72.6% ）. Ratio of the pa- tients with complicated with urinary tract infection in all patients was 85.3 % （81 cases）. Infection induced by Esch- erichia coli and mixed bacteria was the primary cause for urinary tract infection. Logistic regression analysis results showed： Sledal was significantly correlated with the incidence of urinary tract infection （OR = 3. 274 ,P 〈 0.01 ）and blood white cells and platelets to reduce also had significant correlation with the incidence of urinary tract infection （ OR = 2. 454, OR = 2. 133,P 〈 0. 05 ）. Conclusion Urinary tract infection is related to SLE, especially complicat- ed with urinary tract infection. The main pathogenic bacterium of urinary tract infection is Escherichia coll.