Clinical Features And Risk Factors Of Systemic Lupus Erythematosus With Pulmonary Infections

PurposeTo investigate clinical characteristics and risk factors of pulmonary infection in patients hospitalized with systemic lupus erythematosus(SLE),and provide basis for the prevention and timely diagnosis of pulmonary infections.MethodsThe patients with systemic lupus erythematosus who were hospitalized in the First Affiliated Hospital of Anhui Medical University and Anhui Provincial Hospital from January to December 2019 were include.According to whether pulmonary infection occurred,patients were divided into pulmonary infection group and non-pulmonary infection group.The self-designed form was used to collect data,including general demographic data,clinical manifestations of systemic lupus erythematosus patients at the time of admission,laboratory examination indicators,and medication use.Perform data processing and analysis.The t test,Mann-Whitney rank sum test,?~2and Fisher exact probability method,Logistic regression analysis were used.P<0.05 is considered statistically significant.ResultsThis study ultimately included 695 SLE patients,168 patients with pulmonary infection,and 527 patients without pulmonary infection.The age of the infection group was elder than non-infection group(44.9±15.2 vs 39.5±14.6,P<0.05);the length of hospital stay of infection group was longer than non-infection group(14(10-22))vs 9(7-14),P<0.05);the distribution of BMI between the two groups was similar(?~2=3.21,P>0.05);there was no difference in pulse pressure difference(mm Hg)between two group.There was no difference in the patient’s disease activity,use of glucocorticoids,hydroxychloroquine and immunosuppressant between the two groups.The incidence of fever in the pulmonary infection group was greater than non-pulmonary infection group(41.7%vs 28.1%,P<0.05).There were no differences in the incidence of Raynaud phenomenon,stiffness,rash,joint pain,arthritis,dry mouth,dysphagia,hair loss,vasculitis,rash,erythema,photosensitivity,oral ulcers,kidney damage and neurological damage(P>0.05).The white blood cell count,neutrophil count and red blood cell volume distribution width of pulmonary infection group were higher than non-pulmonary infection group(P<0.05);hemoglobin,lymphocyte,red blood cell count,eosinophil count and hematocrit of pulmonary infection group were higher than non-pulmonary infection group(P<0.05);there was no difference between platelet count,monocyte count,basophil count,mean corpuscular volume,mean corpuscular hemoglobin and mean corpuscular-hemoglobin concentration(P>0.05).There was no difference in the positive rate of urinary cast,urine occult blood and urine protein(P>0.05).Albumin in the pulmonary infection group was lower than non-pulmonary infection group(P<0.05);urea,creatinine and blood glucose was higher than the non-pulmonary infection group(P<0.05).There was no difference in alanine aminotransferase,aspartate aminotransferase,uric acid,and globulin between the two groups(P>0.05).The thrombin time of the pulmonary infection group was lower than non-pulmonary infection group(P<0.05).Prothrombin time,prothrombin time international normalized ratio,activated partial thromboplastin time,fibrinogen and D-dimer in the pulmonary infection group were higher than non-pulmonary infection group(P<0.05).C-reactive protein in pulmonary infection group was higher than that in non-pulmonary infection group(P<0.05).There was no difference in immunoglobulin(Ig G,Ig A,Ig M),complement 3,complement 4 and erythrocyte sedimentation rate between the two groups(P>0.05).The positive rates of anti-nuclear antibody,anti-nucleosomes antibody,anti-Scl-70antibody and anti-Ro/SSA(52)antibody in the pulmonary infection group were higher than non-pulmonary infection group(P<0.05).There was no difference in anti-histone antibody,anti-centromere B protein antibody,anti-double-strand DNA antibody,anti-Jo-1 antibody,anti-La/SSB antibody,anti-ribosomal P-protein antibody,anti-Ro/SSA(60)antibody,anti-Sm D1 antibody and anti-U1 small ribonucleo protein antibody between the two groups(P>0.05).Age,low hemoglobin,white blood cell count,low protein,C-reactive protein,anti-nucleosome antibody,anti-Scl-70 antibody,hematocrit,prothrombin time are related to SLE patients with pulmonary infection.ConclusionCompared with the non-pulmonary infection group,the SLE patients with pulmonary infection group are older,have longer length of hospital stay,higher white blood cell count,poor renal function,poor nutritional status,higher levels of inflammatory factors and autoantibodies.In SLE patients,age,low hemoglobin,white blood cell count,low protein,C-reactive protein,anti-nucleosome antibody,anti-Scl-70antibody,hematocrit and prothrombin time may be the risk factors of infection.