380例狼疮性肾炎并发感染者的回顾性分析

目的探讨狼疮性肾炎（LN）患者治疗过程中合并感染的流行病学特征，并分析其特点。方法回顾性分析本院2010年1月至2013年5月收治的共380例狼疮性肾炎患者的临床资料，对其在治疗过程中感染发生的时期、部位、病原体种类及总感染率进行分析。结果104例患者共发生119次感染（2次感染者11例，3次感染者2例），感染发生率为27．4％，感染例次数为31．3％。63例次（52．9％）感染发生在诱导期，发生时间为（2．5±0．9）个月，56例次（47．1％）发生于维持期，发生时间（19．7±9．8）个月。感染发生部位以皮肤软组织（44．5％）、肺（22．7％）及泌尿系统（20．1％）为主。诱导期感染以皮肤软组织感染率最高，其次分别为肺部感染、泌尿系统感染；维持期感染以泌尿系统感染最高，其次分别为皮肤软组织感染率和肺部感染，差异均具有统计学意义（x^2=5．751、4．762、15．010，P〈0．05）。感染中以细菌感染最常见，其次为病毒、真菌感染。诱导期病毒及细菌感染比例较高，而维持期细菌感染比例高，差异均具有统计学意义（x^2=13．968、10．776、4．175，P〈0．05）。结论LN患者在诱导治疗的前3个月为感染高发期，感染的部位及病原体种类在诱导治疗期与维持治疗期均存在差异。

Retrospective analysis of 380 cases with lupus nephritis concurrent infection

Objective To analyze the clinical characteristics and epidemiological characteristics of the incidence of infection during treatment of the patients with lupus nephritis. Methods The clinical data of 380 cases of patients with lupus nephritis from January 2010 to May 2013 were analyzed, retrospectively. The time, location, type of pathogens and the total prevalence of the infection were analyzed, respectively. Results A total of 104 patients and 119 infection episodes were collected （twice episodes in 11 cases and three times of episodes in 2 cases）. There were 52.9% infections occurring in the induction period （2.5 ± 0.9 months） in contrast to 47.1% occurring during the maintenance period （19.7 ± 9.8）. The sites of infection mainly occurs in the skin tissue （induction period）, lung and urinary tract （maintenance period） （x^2= 5.751, 4.762, 15.010; P all 〈 0.05）. Infection were mostly bacterial, then followed by viral and fungal infections. Thereinto, virus and fungal infections were found have higher proportion during induction period, while bacterial infection were found have higher proportion during the maintenance period, with significant differences （x^2= 13.968, 10.776, 4.175; P all 〈 0.05）. Conclusions The first three months of induction therapy of patients with LN has high incidence of infection, and the sites of infection and pathogen species are different between the induction treatment and maintenance treatment period.