系统性红斑狼感染的危险因素:一个元分析
Yanan Xuan1, Jin Wang1, Yi Yuan1
1Department of Rheumatology and Immunology Care, Southern Medical University Hospital of Integrated Traditional Chinese and Western Medicine, Guangzhou, 510300, Guangdong, China.
Immunologic research
|July 4, 2025
概括
系统性红斑狼 (SLE) 患者由于免疫功能障碍而面临更高的感染风险. 关键的危险因素包括年龄较大,男性性别,活跃疾病,糖尿病,损伤,高剂量葡萄糖皮质类药物,免疫抑制剂,淋巴缺血和低补体3 (C3).
科学领域:
- 类风湿病学 类风湿病学
- 传染性疾病 传染性疾病
- 临床免疫学临床免疫学
背景情况:
- 系统性红斑狼 (SLE) 是一种自身免疫性疾病,其特征是免疫功能障碍.
- 这种免疫功能障碍增加了对感染的易感性,使患者管理复杂化并影响临床结果.
研究的目的:
- 进行元分析,以确定和评估与SLE患者感染风险增加相关的因素.
- 为高风险SLE患者制定有针对性的感染预防策略提供信息.
主要方法:
- 在PubMed,Web of Science,Embase和Scopus数据库中进行了全面的文献搜索,截至2023年11月.
- 在使用纽卡斯尔-太华尺度进行质量评估后,包括了21项相关研究.
- 使用R软件 (版本4.3.1) 进行了元分析,以分析包括年龄,性别,疾病活性,并发症和治疗等因素.
主要成果:
- 在SLE患者中发现的重要感染风险因素包括:年龄 (OR=1.02),男性性别 (OR=1.66),活跃疾病阶段 (OR=1.74),糖尿病 (OR=1.64),脏损伤 (OR=1.78),高剂量的葡萄皮质类药物 (OR=2.40),免疫抑制药物 (OR=2.24),淋巴衰竭 (OR=3.59),以及低补体3 (C3) 水平 (OR=2.38).
- 几率比率表明,与淋巴缺血和低C3水平相关的感染风险大幅增加.
结论:
- 高龄,男性性别,活跃疾病,糖尿病,损伤,高剂量葡萄糖皮质类药物治疗,免疫抑制剂使用,淋巴缺血和低C3水平与SLE患者感染风险增加有关.
- 这些发现强调了需要针对SLE管理中已识别的风险因素量身定制的个性化感染预防策略.
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