Analysis Of Clinical Characteristic And Risk Factors Of Infection In Patients With Lupus Nephritis

Objective:To explore the clinical characteristics and related risk factors of infection in patients with lupus nephritis.Methods:Using the method of a retrospective case-control study and searching medical records of all patients diagnosed with lupus nephritis from January 2012 to January2019 through the Jiangxi Provincial People's Hospital Medical Record Inquiry System.All participants were divided into the infection group(n=161)and the non-infection groups(n=153).The related data of the two groups were collected.The collected data were analyzed by SPSS 23.0 statistical software.The differences between the two groups were analyzed by means of c2 test,t-test,and rank-sum test.Logistic regression analysis was used to identify the risk factors for the infection of lupus nephritis.Results:1.The difference of the following data was statistically significant(P <0.05):Course of disease,length of hospital stay,SLEDAI score,blood leucocyte count,serum creatinine,serum albumin,complement C3,erythrocyte sedimentation rate,C-reactive protein,D-dimer,fibrinogen,IgG,24 hours Urinary protein quantification.2.LN patients who used antibiotics 2 weeks before an infection,used daily dose of hormones above 0.5 mg/kg,used more than two immunosuppressive agents,used shock therapy in the past and had multiple systems involved were more susceptible to infection(P <0.05).3.In this study,161 patients with LN had a total of 172 infections,the common infection sites were respiratory tract(66.2%),followed by urinary tract infections(13.9%).A total of 94 pathogenic bacteria were isolated,mainly Gram-negative bacteria(40.4%),followed by fungi(25.5%).4.Univariate logistic regression analysis demonstrated: hospitalization days,CRP,ESR,24-hour urine protein quantitation and serum creatinine,IgG,C3,serumalbumin,previous use of shock therapy,application of multi immunosuppressive,multiple system involvement,high SLE disease activity index,and application of antibiotics 2 weeks before infection,daily dose of hormone were associated with infection in patients with LN(P<0.05).5.Multivariate logistic regression analysis demonstrated: CRP,C3,serum albumin,hospitalization days,application of antibiotics 2 weeks before infection and a daily dose of the hormone were risk factors of infection in patients with LN(P<0.05).Conclusion:LN patients with infection had a long course of the disease,long length of hospital stay,high SLEDAI score,high level of blood leucocyte count,serum creatinine,erythrocyte sedimentation rate,CRP,D-dimer,fibrinogen,high 24-hour urine protein and low level of IgG,serum albumin and complement C3.The most common site of concurrent infection in LN patients is the respiratory system,followed by the urinary system.The most common pathogen is Gram-negative bacteria,followed by fungi.Increased CRP,decreased C3,decreased serum albumin,prolonged length of hospital stay,antibiotics 2 weeks before infection,and the daily dose of the hormone were independent risk factors for infection in patients with lupus nephritis.