系统性红斑狼中尿路感染:来自发展中国家的报告
M A K Azad1, M N Islam, M R Choudhury
1Dr Mohammad Abul Kalam Azad, Assistant Professor, Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;
Mymensingh medical journal : MMJ
|December 31, 2024
概括
尿路感染 (UTI) 在全身性狼发疹 (SLE) 患者中很常见,大肠杆菌是最常见的病原体. 狼性炎和循环胺的使用是SLE中尿路感染的重要风险因素.
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 尿路感染 (UTI) 是系统性红斑狼 (SLE) 患者发病和死亡的重要原因.
- 了解SLE中尿路感染的频率,致病生物和风险因素对于患者管理至关重要.
- 之前的研究表明,SLE患者对感染的敏感性更高,但该群体对尿路感染的具体数据需要进一步调查.
研究的目的:
- 在被诊断为全身性红斑狼 (SLE) 的患者中确定尿路感染 (UTI) 的频率.
- 在这个患者队列中确定导致尿路感染的常见微生物.
- 调查与SLE患者尿路感染发展相关的潜在风险因素.
主要方法:
- 进行了一项观察性研究,涉及169名连续SLE患者在风湿学狼诊所.
- 评估了尿路症状的患者,并收集了人口统计,疾病活性 (SLEDAI),器官损伤 (SLICC/ACR) 和药物使用 (类固醇,HCQ,MMF,阿扎西奥普林,环胺) 的数据.
- 实验室调查包括血清标记物 (C3,C4,CRP,ANA,anti-ds DNA,CBC) 和尿液分析与培养和敏感性测试.
主要成果:
- 在169名注册患者中,150人完成了这项研究,其中40名患者被诊断患有尿路感染,导致尿路感染率为28.57%.
- 大肠杆菌 (E. coli) 是最常被发现的生物体,占尿路感染病例的52.5%.
- 双变体分析确定了高疾病活性 (SLEDAI),严重器官损伤 (SLICC得分),狼性炎和环胺使用作为危险因素. 多变量分析证实,环胺是显著的独立风险因素.
结论:
- 系统性红斑狼 (SLE) 患者的尿路感染的频率特别高.
- 过去患有狼性炎的病史和使用环胺被确定为SLE中发生尿路感染的重要危险因素.
- 这些发现强调了对SLE患者的尿路感染监测和预防策略的重要性,特别是那些患有狼性炎或接受免疫抑制疗法 (如环胺) 的患者.
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