Ginzler E, Diamond H, Kaplan D, Weiner M, Schlesinger M, Seleznick M
Arthritis Rheum. 1978 Jan-Feb;21(1):37-44. doi: 10.1002/art.1780210107.
Data from a prospective study of the clinical course in 223 patients with systemic lupus erythematosus followed for 655 patient-years were analyzed by computer to determine the influence on frequency of infection of 1) corticosteroid dose; 2) azathioprine; 3) active disease, measured by new disease exacerbations, elevated ESR, hypocomplementemia, active urinary sediment, and proteinuria; 4) uremia; and 5) leukopenia. The frequency of all infections, and of bacterial and opportunistic infections specifically, increased progressively with increasing steroid dose. Azathioprine use, independent of steroid dose, did not account for an increased risk of bacterial, opportunistic, or nonspecific viral infections. Leukopenia did not predispose to infection, except possibly when associated with azathioprine-induced bone marrow suppression. Active renal disease, especially when manifested by abnormal urine sediment, was associated with an increase in infection frequency.
对223例系统性红斑狼疮患者进行前瞻性研究，随访655患者年，其临床病程数据经计算机分析，以确定以下因素对感染频率的影响：1）皮质类固醇剂量；2）硫唑嘌呤；3）活动性疾病，通过新的疾病加重、血沉升高、补体降低、活动性尿沉渣和蛋白尿来衡量；4）尿毒症；5）白细胞减少。所有感染以及细菌感染和机会性感染的频率均随类固醇剂量增加而逐渐升高。使用硫唑嘌呤，与类固醇剂量无关，并未导致细菌、机会性或非特异性病毒感染风险增加。白细胞减少本身并不易引发感染，除非可能与硫唑嘌呤引起的骨髓抑制相关。活动性肾脏疾病，尤其是表现为尿沉渣异常时，与感染频率增加相关。
