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病例分析

天疱疮患者合并感染的特征及高危因素分析

  • 郑小苹1 ,
  • * ,
  • 周斐然2 ,
  • * ,
  • 李仲华3 ,
  • 杨清銮2 ,
  • 杨逸轩2 ,
  • 邵凌云2 ,
  • 阮巧玲2
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  • 1. 浙江省温州医科大学附属平阳医院,浙江 温州 325035;  2. 复旦大学附属华山医院,上海 200040;  3. 江苏省太仓市第一人民医院,江苏 苏州 215413

收稿日期: 2022-08-30

  网络出版日期: 2023-06-25

基金资助

上海市科委重点实验室项目(20dz2210401)

Characteristics and risk factors of infections in pemphigus patients

  • ZHENG Xiaoping1 ,
  • * ,
  • ZHOU Feiran2 ,
  • * ,
  • LI Zhonghua3 ,
  • YANG Qingluan2 ,
  • YANG Yixuan2 ,
  • SHAO Lingyun2 ,
  • RUAN Qiaoling2
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  • 1. Pingyang Hospital Affiliated to Wenzhou Medical University, Wenzhou 325035, Zhejiang Province, China;  2. Huashan Hospital, Fudan University, Shanghai 200040, China;  3. The First People’s Hospital of Taicang, Suzhou 215413, Jiangsu Province, China

Received date: 2022-08-30

  Online published: 2023-06-25

摘要

天疱疮患者易合并感染。本研究旨在通过分析天疱疮患者合并感染的特征及危险因素,为临床治疗及预防提供指导。回顾性分析 2017年1月—2021年12月于复旦大学附属华山医院住院治疗的142例天疱疮患者中合并感染的发生率、易感部位及主要病原体分布,通过单因素和多因素Logistic回归分析,明确合并感染的危险因素。142例天疱疮患者中,有74例(52.1%)合并感染。对相关危险因素进行单因素分析,发现感染组中合并低白蛋白血症者占27.0%(P<0.001),使用全身糖皮质激素者占83.3%(P<0.001),且3个月内糖皮质激素累计剂量较大(P=0.001)。多因素分析显示,合并低白蛋白血症(OR=7.96,95% CI为[1.95,32.41])和使用全身糖皮质激素(OR=6.47,95% CI[2.73,15.33])是天疱疮患者合并感染的危险因素。天疱疮患者合并感染的易感部位为创面及肺部,主要病原体为金黄色葡萄球菌及铜绿假单胞菌。本研究证实,低白蛋白血症和使用较高剂量的糖皮质激素是天疱疮患者合并感染的危险因素,应及早针对相关因素采取合理措施,从而有效预防及控制感染的发生。

本文引用格式

郑小苹1 , * , 周斐然2 , * , 李仲华3 , 杨清銮2 , 杨逸轩2 , 邵凌云2 , 阮巧玲2 . 天疱疮患者合并感染的特征及高危因素分析[J]. 微生物与感染, 2023 , 18(3) : 157 -162 . DOI: 10.3969/j.issn.1673-6184.2023.03.005

Abstract

Pemphigus patients have a higher risk of infections. The present paper aims to analyze the characteristics and risk factors of infections in pemphigus patients, and to provide guidance for clinical treatment and prevention. A total of 142 pemphigus patients hospitalized in Huashan Hospital, Fudan University from January 2017 to December 2021 were enrolled. The informations including infection rate, infection site and pathogen distribution were collected through medical records and laboratory results. Univariate analysis and multivariate Logistic regression analysis were performed to identify the risk factors of infections. There were 74 (52.1%) pemphigus patients with infections. Univariate analysis of risk factors showed that in the infection group 27.0% patients had hypoalbuminemia (P<0.001), 83.3% patients adopted systemic glucocorticoid treatment (P<0.001), and the patients in general used higher cumulative dose of glucocorticoids in the recent 3 months (P=0.001). Multivariate Logistic regression analysis showed that hypoalbuminemia (OR=7.96,95% CI is [1.95, 32.41]) and systemic glucocorticoid treatment (OR=6.47,95% CI is [2.73, 15.33]) were risk factors of infections in pemphigus patients. The most susceptible sites of infections were wound surface and lung, and the most common pathogens were Staphylococcus aureus and Pseudomonas aeruginosa. It is suggested that hypoalbuminemia and systemic glucocorticoid treatment were risk factors of infections in pemphigus patients. Related measures should be taken as early as possible to prevent and control the infections.
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