系统性红斑狼疮患者深部真菌感染的相关危险因素及生物学指标的研究进展

 系统性红斑狼疮（SLE）患者合并深部真菌感染（IFI）的发病率高，预后较差。感染部位主要为血液、呼吸系统、皮肤软组织及中枢神经系统；致病菌多为新型隐球菌、白念珠菌、烟曲霉菌等。SLE患者发生IFI的危险因素十分复杂，糖皮质激素的应用以及SLE活动性评分高是较明确的危险因素。SLE患者真菌感染的相关生物学检测指标新进展较少，包括白念珠菌芽管抗体、隐球菌抗原检测、聚合酶链式反应、病原体宏基因组检测等。相关指标的灵敏度及特异度，以及应用于临床的可操作性均需进一步的探索和临床实践。应从SLE患者的相关危险因素、生物学指标，并结合临床症状、体征、用药情况等综合分析，才能作出较为准确的判断。

Advances in risk factors and biomarkers of invasive fungal infection in patients with systemic lupus erythematosus

Patients with systemic lupus erythematosus (SLE) have a high incidence of invasive fungal infection (IFI) and poor prognosis. The main infection sites are blood, respiratory system, skin soft tissue and central ner-vous system; most pathogens were Cryptococcus neoformans, Candida albicans, Aspergillus fumigatus and so on. Risk factors of IFI in SLE patients are very complex, the application of glucocorticoid and high score of SLE activity are definite risk factors. There is little progress in the detection of biomarkers of fungal infection in SLE patients, including detection of Candida albicans germ tube antibody and cryptococcal antigen, polymerase chain reaction, as well as detection of pathogen metagenome. Sensitivity and specificity of the relevant biomarkers, as well as the feasibility of the clinical application need further exploration and clinical practice. The accurate judgment can be made only through analysis on risk factors, biomarkers, clinical symptoms, signs and drug use of SLE patients.