[1]郭芸,谈鑫,邸宇姿,等.系统性红斑狼疮并发侵袭性真菌病27例临床分析[J].中国皮肤性病学杂志,2017,(09):980-983.[doi:10.13735/j.cjdv.1001-7089.201701095]
 GUO Yun,TAN Xin,DI Yu-zi,et al.Analysis of 27 Cases of Patients with Systemic Lupus Erythematosus Accompanied with Invasive Fungal Disease[J].The Chinese Journal of Dermatovenereology,2017,(09):980-983.[doi:10.13735/j.cjdv.1001-7089.201701095]
点击复制

系统性红斑狼疮并发侵袭性真菌病27例临床分析
分享到:

《中国皮肤性病学杂志》[ISSN:1001-7089/CN:61-1197/R]

卷:
期数:
2017年09期
页码:
980-983
栏目:
临床经验
出版日期:
2017-09-01

文章信息/Info

Title:
Analysis of 27 Cases of Patients with Systemic Lupus Erythematosus Accompanied with Invasive Fungal Disease
作者:
郭芸1谈鑫2邸宇姿3邓丹琪1吴永卓1高远1何静1张丹1
1.昆明医科大学第二附属医院皮肤科,云南 昆明650101; 2.湖南省儿童医院皮肤科,湖南 长沙 410007; 3.郑州市儿童医院皮肤科,河南 郑州 450053
Author(s):
GUO Yun1TAN Xin2DI Yu-zi3DENG Dan-qi1WU Yong-zhuo1GAO Yuan1HE Jing1ZHANG Dan1
1.Department of Dermatology,the Second Affiliated Hospital of Kunming Medical University, Kunming 650101, China; 2.Department of Dermatology,Hunan Children's Hospital,Changsha 410007,China; 3.Department of Dermatology,Zhengzhou Children's Hospital,Zhengzhou 450053, China
关键词:
系统性红斑狼疮 侵袭性真菌病
Keywords:
Systemic lupus erythematosus Invasive fungal disease
分类号:
R 593.24
DOI:
10.13735/j.cjdv.1001-7089.201701095
文献标志码:
B
摘要:
目的 探讨系统性红斑狼疮(SLE)并发侵袭性真菌病(IFD)的临床特征。方法 对2009年1月-2013年12月在本科住院的803例SLE患者临床资料进行分析,比较合并IFD与未合并IFD患者的临床特点。结果 SLE并发IFD者27例,没有确诊的病例; 从27例IFD患者中分离到33株真菌,其中白念珠菌30株(90.91%)、光滑念珠菌2株、克柔念珠菌1株,标本分别来源于下呼吸道、消化道和泌尿道; 抗真菌治疗均有效。疑似感染症状,SLEDAI≥9,CRP≥0.8mg/dL为SLE合并IFD的独立危险因素。结论 本科SLE并发IFD的患者发生率为3.36%,致病菌以白念珠菌为主,氟康唑是有效的抗真菌治疗药物之一。
Abstract:
Objective To analyze the clinical features of the patients with systemic lupus erythematosus(SLE)accompanied with invasive fungal disease(IFD).Methods Data of 803 SLE inpatients were researched, ranging from January 2009 to December 2013, who were adopted in our department.Clinical data of two groups were compared to reveal the clinical features of SLE accompanied with IFD and without IFD.Results There were 27 cases of SLE with IFD, no patients were confirmed as IFD.There were 33 strains fungi isolated from the 27 patients with IFD, included 30 strains(90.91%)Candida albicans, 2 strains Candida glabrata and 1 strain Candida krusei.The 33 strains fungi were identified from lower respiratory tract, gastrointestinal tract and urinary tract of the 27 IFD patients.The antifungal treatment was effective.Suspected infection symptoms, the score of SLEDAI≥9,CRP≥0.8mg/dL were independent risk factors of SLE accompanied with IFD.Conclusion For SLE patients admitted in our department, the incidence of accompanying IFD is 3.36%, Candida albicans is the main pathogen and fluconazole is one of the effective treatments.

参考文献/References:

[1] 胡炯.血液病/恶性肿瘤患者侵袭性真菌病的诊断标准与治疗原则(第四次修订版)解读[J].中华内科杂志,2013,52(8):710-711.
[2] Caston-Osorio JJ,Rivero A,Torre-Cisneros J.Epidemiology of invasive fungal infection [J].Int J Antimicrob Agents,2008,32(2):S103-109.
[3] James JA,Robertson JM.Lupus and Epstein-Barr[J].Curr Opin Rheumatol,2012, 24(4): 383-388.
[4] 詹钟平,梁柳琴,陈冬莹,等.系统性红斑狼疮合并深部真菌感染102例临床分析[J].新医学,2008,39(9):578-580.
[5] 中华人民共和国卫生部.医院感染诊断标准(试行)[J].中华医学杂志,2001,81(5):61-67.
[6] De Pauw B, Walsh TJ, Donnelly JP, et al.European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group; National Institute of Allergy and Infectious Diseases Mycoses Study Group(EORTC/MSG)Consensus Group, 2008.Revised definitions of invasive fungal disease from the European Organization for research and treatment of cancer/invasive[J].Clinical Infecrious Diseases,2008, 46(12): 1813-1821.
[7] Al-Rayes H, Al-Swailem R, Arfin M,et al.Systemic lupus erythematosus and infections:a retrospective study in Saudis[J].Lupus,2007,16(9):755-763.
[8] 王春燕,李挺.系统性红斑狼疮真菌感染的易感因素分析[J].兰州大学学报(医学版),2013,39(4):37-40.
[9] Wang LR, Barber CE, Johnson AS, et al.Invasive fungal disease in systemic lupus erythematosus: a systematic review of disease characteristics, risk factors, and prognosis[J].Seminars in Arthritis and Rheumatism,2014,44(3):325-330.
[10] Vinicki JP, Catalan Pellet S, Pappalardo C, et al.Invasive fungal in fectionsin Argentine patients with systemic lupus erythematosus [J].Lupus, 2013,22(9):892-898.
[11] 刘红,刘丹,周科,等.红斑狼疮患者深部真菌感染危险因素及预防对策[J].中华医院感染学杂志,2013,23(13):3123-3125.
[12] 孙琳,潘秀霞,马京平,等.系统性红斑狼疮患者深部真菌感染病原学分析与临床治疗研究[J].中华医院感染学杂志,2015,25(8):1738-1740.
[13] Larbcharoensub N, Srisuma S, Ngernprasertsri T,et al.Invasive fungal infection in Ramathibodi Hospital:a ten-yearautopsy review[J].J Med Assoc Thai, 2012,90(12):2630-2637.
[14] 刘雪艳,郑秀芬,王冰,等.系统性红斑狼疮患者真菌感染的调查研究[J]. 中国麻风皮肤病杂志,2011,27(9):622-623.
[15] 邓红香,游运辉,刘萍,等.系统性红斑狼疮继发深部真菌感染的临床研究[J].中南大学学报(医学版),2013,38(2):182-185.
[16] 章强强.我国深部真菌感染及其检测的现状分析[J].实用皮肤病学杂志,2011,4(3):129-132.
[17] Vautier S, MacCallum DM, Brown GD, et al.C-type lectin receptors and cytokines in fungal immunity[J].Cytokine, 2012, 58(1): 89-99.
[18] Chen D, Xie J, Chen H,et al.Infection in Southern Chinese patients with systemic lupus erythematosus: spectrum, drug resistance, outcomes, and risk factors[J].The Journal of Rheumatology, 2016,43(9):1650-1656.
[19] Chen GL, Chen Y, Zhu CQ, et al. Invasive fungal infection in Chinese patients with systemic lupus erythematosus[J].Clin Rheumatol,2012,31(7): 1087-1091.
[20] Fan YC, Li WG, Zheng MH, et al. Invasive fungal infection in patients with systemic lupus erythematosus: experience from a single institute of Northern China[J].Gene,2012,506(1):184-187.

相似文献/References:

[1]王蓉,李桂珍,陈雪雯,等.系统性红斑狼疮患者外周血T淋巴细胞的激活状态[J].中国皮肤性病学杂志,2015,(02):111.[doi:10.13735/j.cjdv.1001-7089.201408034]
 WANG Rong,LI Gui zhen,CHEN Xue wen,et al.T Lymphocytes Activity in Peripheral Blood of Patients with Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2015,(09):111.[doi:10.13735/j.cjdv.1001-7089.201408034]
[2]王倩,刘伟,卢葳,等.系统性红斑狼疮患者血清中趋化因子CXCL9,CXCL10及CXCL11的检测[J].中国皮肤性病学杂志,2015,(02):125.[doi:10.13735/j.cjdv.1001-7089.201405189]
 WANG Qian,LIU Wei,LU Wei,et al.Detection of Chemokine CXCL9,CXCL10 and CXCL11 in the Serum of Patients with Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2015,(09):125.[doi:10.13735/j.cjdv.1001-7089.201405189]
[3]张娜,付学锋,陈筱筱,等.干燥综合征108例临床分析[J].中国皮肤性病学杂志,2015,(04):368.[doi:10.13735/j.cjdv.1001-7089.201408102]
 ZHANG Na,FU Xue feng,CHEN Xiao xiao,et al.Clinical Analysis in 108 Patients with Sjgren′s Syndrome[J].The Chinese Journal of Dermatovenereology,2015,(09):368.[doi:10.13735/j.cjdv.1001-7089.201408102]
[4]周冼苡䥺Symbol`@@,杨烨玫,周思彤.微波联合光动力疗法治疗系统性红斑狼疮并尖锐湿疣1例[J].中国皮肤性病学杂志,2015,(06):608.[doi:10.13735/j.cjdv.1001-7089.201411120]
 ZHOU Xian yi,YANG Ye mei,ZHOU Si tong.Microwave Combined with Photodynamics for Condyloma Acuminatum in Patient with Systemic Lupus Erythematosus Patient: a Case Report[J].The Chinese Journal of Dermatovenereology,2015,(09):608.[doi:10.13735/j.cjdv.1001-7089.201411120]
[5]梅莉红,干慧慧,翁孟武,等.系统性红斑狼疮患者血清中肺炎衣原体感染的检测[J].中国皮肤性病学杂志,2015,(07):670.[doi:10.13735/j.cjdv.1001-7089.201410048]
 MEI Li hong,GAN Hui hui,WENG Meng wu,et al.Detection of Chlamydia Pneumoniae Antibodies in Serum of Patients with Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2015,(09):670.[doi:10.13735/j.cjdv.1001-7089.201410048]
[6]卢井发,叶小英,万春雷,等.系统性红斑狼疮、多发性肌炎和系统性硬皮病重叠综合征1例[J].中国皮肤性病学杂志,2015,(09):941.[doi:10.13735/j.cjdv.1001-7089.201501068]
 LU Jing fa,YE Xiao ying,WAN Chun lei,et al.A Case of Overlap Syndrome with Systemic Lupus Erythematosus,Polymyositis and Systemic Scleroderma[J].The Chinese Journal of Dermatovenereology,2015,(09):941.[doi:10.13735/j.cjdv.1001-7089.201501068]
[7]冉昕,邓丹琪.系统性红斑狼疮与地理环境因素的研究进展[J].中国皮肤性病学杂志,2015,(10):1082.[doi:10.13735/j.cjdv.1001.7089.201408120]
 RAN Xin,DENG Dan qi.Research Progress on Environmental Factors in Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2015,(09):1082.[doi:10.13735/j.cjdv.1001.7089.201408120]
[8]朱小华,梁俊,杨永生,等.SLE患者外周血T淋巴细胞p53基因表达及其与DNA甲基化的相关性[J].中国皮肤性病学杂志,2016,(04):334.[doi:10.13735/j.cjdv.1001-7089.201504065]
 ZHU Xiao hua,LIANG Jun,YANG Yong sheng,et al.Associations Between Expression of p53mRNA and DNA Methylation in T Cells From the Patients With Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2016,(09):334.[doi:10.13735/j.cjdv.1001-7089.201504065]
[9]韩露露,钱革,胡桂兰,等.UVB照射对系统性红斑狼疮自噬相关基因及蛋白表达水平的影响[J].中国皮肤性病学杂志,2016,(05):445.[doi:10.13735/j.cjdv.1001-7089.201506182]
 HAN Lu lu,QIAN Ge,HU Gui lan,et al.The Influence of UVB Irradiation on the Expression Levels of Autophagy Related Proteins and Genes in Systemic Lupus Erythematosus[J].The Chinese Journal of Dermatovenereology,2016,(09):445.[doi:10.13735/j.cjdv.1001-7089.201506182]
[10]赵俊芳,李桂珍,李孟娟.SLE患者抗核小体抗体、抗dsDNA抗体及抗C1q抗体的检测[J].中国皮肤性病学杂志,2017,(02):156.[doi:10.13735/j.cjdv.1001-7089.201609041]
 ZHAO Jun-fang,LI Gui-zhen,LI Meng-juan.Detection of Anti-nucleosome Antibody,Anti-C1q Antibody and Anti-dsDNA Antibody in Patients with Systemic Lupus Erythematosus(SLE)[J].The Chinese Journal of Dermatovenereology,2017,(09):156.[doi:10.13735/j.cjdv.1001-7089.201609041]

备注/Memo

备注/Memo:
[基金项目] 云南省科技厅-昆医联合项目
更新日期/Last Update: 2017-09-10