Objective To analyze the risk factors for infections and severe infections in SLE patients,and further explore the relationship between lymphocyte subsets and severe infections in SLE.Methods The clinical data of SLE patients were collected,and the levels of peripheral blood lymphocyte subsets were detected by flow cytometry.The clinical data of SLE patients with infection group and non-infection group were compared.The differences of lymphocyte subsets among the infec-ted group,non-infected group and healthy control group were compared.Multivariate binary logistic regression was used to analyze the risk factors of infection in SLE patients.We further compare the differences of lymphocyte subsets in SLE patients with severe infections,non-severe infections and those in the healthy control group,and then use multivariate binary logistic regression to analyze the risk factors of lymphocyte subsets for severe infection in SLE patients,draw the receiver operating characteristic curve(ROC curve)to analyze its critical value for severe infection diagnosis in SLE patients.Results A total of 382 SLE patients were included in the study,94 patients had infection,and the incidence of infection was 24.6%.Among them,4.5%were severely infected.The most common site of infection was the lung,accounting for 43.7%,followed by the upper respiratory tract,accounting for 13.6%.The most common pathogen was bacteria,accounting for 64.9%,followed by viruses,accounting for 12.8%.Compared with the non-in-fected group,the levels of CD4+T cells and CD8+T cells in the peripheral blood of the infected group of SLE patients were significantly decreased(all P<0.05),and there was no significant difference in B cells and NK cells.Among the risk factors of secondary infection in SLE patients analyzed by multivariate binary logistic regression,the differences of C-reactive pro-tein(P=0.012),albumin(P=0.005)and hormone dosage(P=0.026)were statistically significant(all P<0.05).Com-pared with non-severe infection group and healthy control group,CD4+T cells,CD8+T cells,B cells and NK cells in severe infection group were significantly decreased(P<0.05).NK cells(P=0.039,P<0.05)and erythrocyte sedimentation rate(P=0.037,P<0.05)were the risk factors of severe infection in SLE patients,and the critical value of NK cells for the diagnosis of severe infection in SLE was 18/μL.The sensitivity and specificity of diagnosis were 93.2%and 77.8%.Con-clusion According to the analysis of SLE cohort data,the risk factors of infection in SLE patients are the decrease of albu-min,the increase of hormone dosage and the increase of C-reactive protein level.The decrease of NK cells in peripheral blood is a risk factor for severe infection in SLE patients,which might have a promising predictive value for severe infection in SLE patients.
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