Đặc điểm nhiễm khuẩn ở bệnh nhân lupus ban đỏ hệ thống=Characteristics of infections in patients with systemic lupus erythematosus

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Tác giả: Hoàng Phương Nguyễn, Văn Đoàn Nguyễn, Thị Mùi Trần, Thị Hằng Vũ

Ngôn ngữ: vie

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Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.62-70

Bộ sưu tập: Metadata

ID: 244734

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Đặt vấn đề: Nhiễm khuẩn là một trong những nguyên nhân chính dẫn đến tử vong ở bệnh nhân lupus ban đỏ hệ thống (Systemic Lupus Erythematosus-SLE). Mục tiêu: Đánh giá tình trạng nhiễm khuẩn ở bệnh nhân SLE. Phương pháp nghiên cứu: Nghiên cứu tiến cứu mô tả cắt ngang trên 1282 bệnh nhân Lupus ban đỏ hệ thống (Systemic Lupus Erythematosus – SLE) được nhập viện tại Trung tâm Dị ứng – Miễn dịch lâm sàng Bệnh viện Bạch Mai từ 1/6/2018 đến 31/5/2019. Kết quả: 220 bệnh nhân nhiễm khuẩn (17,16%). Nhiễm khuẩn khu trú cơ quan chiếm đa số 84,55%, (chủ yếu gặp cơ quan hô hấp 37,30%), nhiễm khuẩn huyết 11,36%. CRPhs tăng chỉ gặp trong 10% bệnh nhân, Procalcitonin tăng trong 52,7% trường hợp. Vi khuẩn gặp trong nhiễm khuẩn đa số là tụ cầu vàng 39,10%, trực khuẩn mủ xanh 17.40%, lao gặp ít chỉ 4,30%. Bệnh nhân đa số được dùng corticosteroid điều trị 86,36%, HCQ 69,5%. Kết luận: Bệnh nhân SLE hay gặp nhiễm khuẩn hô hấp, nguyên nhân hay gặp do tụ cầu vàng. Thuốc dùng và liều corticosteroid có liên quan nhiễm khuẩn.Introduction: Infections remain one of the leading causes of the death in systemic lupus erythematosus (SLE). The aims: To evaluate the infection status in patiens with SLE. Method: The prospective, cross sectional study was conducted in 1282 patients with SLE at the Center of Allergy and Clinical Immunology, Bach Mai Hospital for 1 year (from June 1, 2018 to May 31, 2019). Results: Among the patients studied, 220 patients (17.16%) sufferd from infection. Localized infections were the majority at 84.55% (the respiratory was the most orrgan effected by infection, with 37.30%). There was septic in 11.36%, septic shock in 4.09% of cases. CRPhs level increased in only 10% of patients, while procalcitonin level increased in 52.7% of cases. The majority of bacteria found in infections were Staphylococcus aureus in 39.10%, Bacillius species in 17.40%, and tuberculosis in only 4.30%. The majority of patients were treated with corticosteroids in 86.36%, HCQ in 69.5%. The average corticosteroid dose over 7.5 mg/day before 1 month of admission to the hospital was in 66.40% of cases. Conclusions: The respiratory tract infection was the most of organ infetion in SLE, staphylococcus aureus was common etiology. Drugs and dose of corticosteroid associated of infectious processes.

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