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目的回顾性分析104例血液病患者行自体外周造血干细胞移植后早期感染(30d内)的发生情况及危险因素。方法收集患者临床资料,记录移植早期感染的发生率、病原菌分布及治疗情况,对患者的性别、年龄、疾病类型以及粒细胞缺乏时间等因素进行回顾性分析。结果 100例患者造血重建,73例(70.19%)在移植后早期发生感染,未发生感染相关死亡。共分离25株病原菌,包括革兰阴性菌10株(40.00%),革兰阳性菌7株(28.00%),真菌8株(32.00%)。粒细胞缺乏时间大于10d是移植后早期感染以及真菌感染发生的危险因素(P分别为0.008和0.044),而性别、年龄及疾病类型对患者的早期感染无显著影响(P<0.05)。结论粒细胞缺乏时间大于10d可能增加自体外周造血干细胞移植后早期感染风险;加速造血重建,缩短粒细胞缺乏时间,预防感染并经验性抗感染治疗,可能降低早期感染的发生率及病死率,提高移植疗效以及患者生存质量。
Objective To retrospectively analyze the incidence and risk factors of early infection (within 30 days) in 104 patients with hematological diseases after autologous peripheral blood stem cell transplantation. Methods The clinical data of patients were collected. The incidence of early infection, distribution and treatment of pathogens were recorded. The factors such as gender, age, type of disease and neutropenia were retrospectively analyzed. Results 100 cases of hematopoietic reconstructions, 73 cases (70.19%) were infected early after transplantation, no infection-related deaths. A total of 25 pathogenic bacteria were isolated, including 10 Gram-negative bacteria (40.00%), 7 Gram-positive bacteria (28.00%) and 8 fungi (32.00%). The number of agranulocytosis more than 10d was a risk factor for early infection and fungal infection after transplantation (P = 0.008 and 0.044, respectively), while gender, age and type of disease had no significant effect on early infection in patients (P <0.05). Conclusions Granulocyte-deficient time> 10 days may increase the risk of early infection after autologous peripheral blood stem cell transplantation. Accelerating hematopoietic reconstitution, shortening the time of agranulocytosis, preventing infection and experiencing anti-infective therapy may reduce the incidence of early infection and increase mortality Transplant efficacy and patient quality of life.