论文部分内容阅读
目的了解恶性血液病并发侵袭性真菌感染者的相关临床信息,以提高疾病的诊疗水平。方法选取某院2010年-2015年收治的恶性血液病并发侵袭性真菌感染的病例,对入选患者进行回顾性分析。结果恶性血液病并发侵袭性真菌感染病例数逐年增加,以急性白血病为最多,约占52.83%,感染部位以肺部感染33例(62.26%)为最多;抗真菌药物的使用,氟康唑22例,伏立康唑31例,近年来伏立康唑使用明显增多。使用糖皮质激素、外周血白细胞计数≦1.0E+9/L、抗生素使用种类≧3种、抗生素使用超过7天均可使真菌感染率明显增加(P<0.05),Logistic回归分析显示:使用糖皮质激素、外周血白细胞计数≦1.0E+9/L、抗生素使用种类≥3种为恶性血液病并发侵袭性真菌感染独立危险因素(OR值分别为130.58、58.5、33.69)。结论对于恶性血液病存在影响因素特别是独立危险因素的患者及时进行抗真菌的二级预防,且尽可能选用广谱抗真菌药。
Objective To understand the clinical information of patients with malignant hematopathy and invasive fungal infection to improve the diagnosis and treatment of the disease. Methods Selected cases of malignant hematological disease complicated with invasive fungal infection in a hospital from 2010 to 2015 were retrospectively analyzed. Results The number of cases of invasive hematologic malignancies complicated with invasive fungal infections increased year by year with the highest number of acute leukemias accounting for 52.83%, and the highest incidence of pulmonary infections was found in 33 (62.26%) cases. The use of antifungal agents, fluconazole 22 Cases, voriconazole in 31 cases, voriconazole use increased significantly in recent years. The use of glucocorticoids, the peripheral blood leukocyte count ≦ 1.0E + 9 / L, antibiotic use ≧ 3 species, the use of antibiotics more than 7 days can make the fungal infection rate increased significantly (P <0.05), Logistic regression analysis showed that: Cortical hormones, peripheral blood leukocyte counts ≦ 1.0E + 9 / L, and antibiotic use types ≥3 were independent risk factors for hematologic malignancy with invasive fungal infection (OR = 130.58, 58.5, 33.69, respectively). Conclusion For patients with hematologic malignancies, especially those with independent risk factors, antifungal secondary prevention should be conducted in time, and if possible, broad-spectrum antifungal drugs should be used.