Analysis On Clinical Feature And Predisposing Factor Of Systemic Lupus Erythematosus Complicated With Pulmonary Infection

Objectives:To get to know the clinical feature and predisposing factor of systemic lupus erythematosus complicated with pulmonary infection; to conduct diagnosis and treatment according to its clinical features and predisposing factors and implement intervening measures on risk factors, so as to provide clinical evidence for the prognosis of SLE patients.Methods:78 SLE patients that had been hospitalized in Second Affiliated Hospital of Kunming Medical University from 2004 to 2014 and had been diagnosed with pulmonary infection were included in the infection group while 78 patients without SLE that had been hospitalized in the same period were included in the none-infection group. These patients were randomly selected from non-SLE patients according to the proportion of 1:1. The general clinical materials, relevant complications, lab indexes, infected pathogenic bacteria, imaging examination, relevant treatment and other items of patients from two groups were analyzed.Results:1. Comparison analysis on clinical materials of infection group and non-infection group:age, disease course, SLEDAI score, combined circulatory system of patients from two groups were involved and the difference had statistical significance (P<0.05).2. The pathogenic bacteria of patients from the infection group are mainly bacteria and gram-negative bacteria (G-) are most common bacteria merging with double fungal infection; among 78 cases, meaningful bacterial strains were detected from 65 cases and among them,11 cases were bacteria merging with fungal infection; there were 32 Gram-negative bacteria, mostly escherichia coli infection; there were 15 Gram-positive (G+) bacteria, mostly staphylococcus aureus; there were 20 fungal strains, with 17 Candida albicans; threre were 3 mycobacterium tuberculosis strains; pathogenic bacterium was not detected in 13 cases.3. Among 78 infected cases,69 cases were confirmed with pulmonary injury by X-ray and/or CT. Among 69 cases,51 cases had pure invasive lesion (65.38%); 4 cases had invasive lesion and pleural effusion; 3 cases had pure pulmonary interstitial lesions’3 cases had pulmonary interstitial lesions and infiltrating lesions; 6 cases had trachitis; 1 case had pure tuberculosis; 1 case had tuberculosis and infiltrating lesions.4. Analysis on lab materials of the infection group and non-infection group:the difference in albumin, globulin, CRP and C3 had statistical significance (P<0.05).5. Drug using condition of patients from SLE infection group and non-infection group before admission:the difference in PDN daily dose of two groups had statistical significance (P<0.05).6. Drug using condition of patients from the infection group at admission:29 cases used hormone, immune suppressor and antibacterial agents and 49 cases used hormone and antibacterial agents.Conclusions:1. The pathogenic bacteria of secondary pulmonary infection in SLE patients are mainly bacterial infections, mostly gram-negative bacteria.2. SLE patients are easily to have pulmonary infection in one year of onset.3. SLE patients complicated with circulatory system damage have a higher risk of pulmonary infection.4. High SLEDAI score, decreased complement C3, increased CRP, decreased albumin, decreased globulin and increased PDN daily dose are predisposing factors that cause pulmonary infection in SLE patients.5. CRP can better reflect the existence of infection than ESR.