急性髓系白血病患者化疗后继发感染的临床特征及危险因素分析

doi:10.3969/j.issn.1006-5253.2022.06.004

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摘要目的探讨急性髓系白血病（AML）患者化疗后继发感染的临床特征及危险因素。方法选取2021年3月—2022年4月在某院行化疗的AML患者作为研究对象，统计患者化疗后继发感染情况，分析2组患者感染特征和临床特征，并采用多因素回归分析AML患者化疗后继发感染的危险因素。结果 186例AML患者中，化疗后继发感染114例，感染率为61.29%；114例AML继发感染患者，共分离出病原菌46株，革兰氏阳性菌12株（26.09%），革兰氏阴性菌25株（54.35%），真菌9株（19.57%）；logistic回归分析显示，年龄>40岁（OR=2.265，95%CI：1.155~4.441）、糖尿病（OR=4.529，95%CI：1.48~13.863）、WBC≤1×10⁹/L（OR=2.818，95%CI：1.246~6.375）、粒细胞缺乏时间>7 d（OR=2.454，95%CI：1.232~4.891）和骨髓原始细胞比例>50%（OR=2.908，95%CI：1.189~7.109）是AML患者继发感染的影响因素。结论 AML患者化疗后继发感染的发生率较高，临床可针对年龄>40岁、糖尿病、WBC≤1×10⁹/L、粒细胞缺乏时间>7 d和骨髓原始细胞比例>50%的患者进行及早预防和对症治疗。

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	刘敏
	李琳洁

关键词 ：急性髓系白血病, 感染, 危险因素

Abstract： Objective To explore the clinical characteristics and risk factors of secondary infection in patients with acute myeloid leukemia (AML) after chemotherapy.Methods Patients with AML undergoing chemotherapy in a hospital from March 2021 to April 2022 were enrolled as the research objects. The secondary infection after chemotherapy was statistically analyzed. The infection characteristics and clinical characteristics in both groups were analyzed. Multivariate regression was used to analyze the risk factors of secondary infection in AML patients after chemotherapy.Results Among 186 AML patients, 114 cases were infected after chemotherapy, and the infection rate was 61.29%. Among 114 patients with AML secondary infection, 46 strains of pathogenic bacteria were isolated, In the 114 AML patients with secondary infection, there were 46 strains of pathogens, including 12 strains of Gram-positive bacteria (26.09%), 25 strains of Gram-negative bacteria (54.35%) and 9 strains of fungi (19.57%). Logistic regression analysis showed that age>40 years old (OR=2.265, 95%CI:1.155-4.441), diabetes mellitus (OR=4.529, 95%CI: 1.48-13.863), WBC≤1×10⁹/L (OR=2.818, 95%CI: 1.246-6.375), agranulocytosis time>7 d (OR=2.454, 95%CI: 1.232-4.891) and ratio of bone marrow blast cells>50% (OR=2.908, 95%CI: 1.189-7.109) were all independent risk factors of secondary infection.Conclusion The incidence of secondary infection is high in AML patients after chemotherapy. Clinically, early prevention and symptomatic treatment can be carried out for patients with age>40 years old, diabetes mellitus, WBC ≤1×10⁹/L, agranulocytosis time>7 d and ratio of bone marrow blast cells>50%.

Key words： acute myeloid leukemia infection risk factor

收稿日期: 2022-07-26

PACS:

基金资助: 浙江省医药卫生科技计划项目（2022KY455）

通讯作者: 李琳洁，Email：Lilinjie0394@163.com

引用本文:

刘敏，李琳洁. 急性髓系白血病患者化疗后继发感染的临床特征及危险因素分析[J]. 中国医院统计, 2022, 29(6): 424-427.
Liu Min， Li Linjie. Clinical characteristics and risk factors of secondary infection in patients with acute myeloid leukemia after chemotherapy. journal1, 2022, 29(6): 424-427.

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