摘要
目的分析狼疮性肾炎的临床特点及病理关系。方法选择2010年9月至2013年12月在我院风湿免疫科住院治疗且并发医院感染的狼疮性肾炎患者75例,分析其临床特点及病理二者关系。结果狼疮性肾炎患者75例中出现医院感染者35例,感染率约为46.67%,感染主要波及肺部及皮肤,消化道及泌尿道;感染病原菌主要为细菌,其中G+菌者18例,约51.43%,G-菌者10例,约28.57%,真菌者7例,约20.00%;按照临床类型分型,感染率分别为急性肾炎综合征型(81.33%,61/75)、急进性肾炎综合征型(74.67%,56/75)、肾病综合征型(57.33%,43/75)、肾炎-肾病综合征型(65.33%,49/75)、尿检异常型(10.67%,8/75)、终末期尿毒症型(9.33%,7/75),前4型与后2型之间感染率差异较大,具有统计学意义,P<0.01;感染率随病理类型恶化而逐渐升高;基于治疗感染疗效,两种方法联合应用明显优于单一方法,(P<0.05);基于患者住院时间及SLEDAI评分,非感染组及感染组之间差异明显(P<0.05);基于血液检测指标,包括血红蛋白、血浆白蛋白,肌酐及补体C3指标,感染组患者及非感染组之间差异明显(P<0.05)。结论狼疮性肾炎在临床需要避免发生医院感染,其病理类型与实验室检查、临床活动性均具有一定的联系,可根据实验室检查及临床活动性积分推测患者可能性病理类型及肾脏损害程度。
Objective The clinical features of lupus nephritis and pathological relationships. Methods September 2010 December 2013 in our hospital inpatient treatment rheumatology and nosocomial infection in patients with lupus nephritis 75 cases analyzed the clinical and pathological features of both relationships. Results 35 cases of nosocomial infection in patients with lupus nephritis 75 cases, the infection rate is about 46.67%, the infection spread to the lungs and major skin, digestive tract and urinary tract; mainly for bacterial infection pathogens, including G＋ bacteria in 18 cases, approximately 51.43%, Gbacteria in 10 cases, approximately 28.57%, fungi were seven cases, approximately 20.00%; type classification based on clinical, infection rates were acute nephritic syndrome type（81.33%, 61/75）, rapidly progressive nephritic syndrome type（74.67%, 56/75）, nephrotic syndrome（57.33%, 43/75）, nephritisnephrotic syndrome（65.33%, 49/75）, urine abnormal type（10.67%, 8 / 75）, end-stage uremia type（9.33%, 7/75）, the difference between the type of infection before and after 4 type 2 large, statistically significant, P〈0.01; with the pathological type of infection worsen gradually increased; based on the efficacy of the treatment of infections, the combination of the two methods was significantly better than a single method（P〈0.05）; based on hospitalization time and SLEDAI scores, the differences between infected and non-infected group was significantly（P〈0.05）. Conclusion Lupus nephritis in clinic to prevent hospital infection, the pathological types and laboratory examination, clinical activity has certain relation, according to the laboratory examination and clinical activity score to speculation patients pathological types and renal damage degree.
出处
《中国医药指南》
2015年第13期156-157,共2页
Guide of China Medicine
关键词
狼疮性肾炎
临床特点
病理类型
医院感染
Lupus nephritis
Clinical features
Pathology
Hospital infection
