系统性红斑狼疮合并深部真菌感染临床分析

目的 探讨系统性红斑狼疮(SLE)合并深部真菌感染的部位、菌种、诊断及预后.方法 回顾性分析北京协和医院2000-2006年住院治疗的1466例SLE患者中合并深部真菌感染的51例患者的临床资料. 结果 合并深部真菌感染51例SLE患者.感染的病原菌以白色念珠菌为主,其次为隐球菌和曲霉菌.感染最常见的部位是肺,其次为脑膜和血液.本组病例巾死亡10例,病死率达20%.曲霉菌感染者病死率高达4/5.低蛋白血症、多部位真菌感染、曲霉菌感染、真菌血症可能是导致SLE患者死亡的独立危险因素. 结论 SLE合并真菌感染的主要部位为肺,感染的病原菌以白色念珠菌为主;临床应重视早期诊断和曲霉菌感染.

Deep fungal infectious in patients with systemic lupus erythematosus:a clinical analysis

Objective To investigate the infection sites,the offending species,diagnosis and prognosis of deep fungal infections (DFI) in patients with systemic lupus erythcmatosus (SLE).Methods Fifty-one patients with fungal infections in 1466 SLE patients admitted to Peking Union Medical College (PUMC) Hospital from 2000 to 2006 were reviewed retrospectively.Results Candida albicans was ranked the first pathogen,followed by ncoformans and Aspergillus species.The infection sites were lungs,cerebral meninges and blood in the order of prevalence.The overall mortality was 20%(10/51).Aspergillasis carried the highest mortality which couht be as high as 80%.Hypoproteinemia,multiple focus of fungal infections,Aspergillasis and fungemia might he the independent risk factor for mortality.Conclusion Candida albicans is the most frequent species of fungal infections in SLE patients.Iungs are the most prevalent location of infection.Earlier diagnosis is important.Special attention should be paid to aspergillasis.