摘要
目的探讨儿童再生障碍性贫血免疫抑制剂治疗期间发生医院感染的临床特征及相关因素。方法分析2000年1月-2007年8月住院且进行免疫抑制剂治疗(IST)的再生障碍性贫血患儿76例,在治疗期间发生医院感染的时间、部位、治疗药物,并分析比较使用抗胸腺细胞免疫球蛋白(ATG)前后及感染前后患儿外周血像的变化。结果再生障碍性贫血患儿感染时最易受累的部位为上呼吸道,其次为口腔黏膜、肺部、胃肠道及肛周,其感染发生率分别为67.3%、16.3%、10.2%、4.1%及2.1%,各部位的感染率差异有统计学意义(P<0.05);再生障碍性贫血患儿IST后外周血白细胞、淋巴细胞百分比、血小板均明显下降,与治疗前比较差异有统计学意义(P<0.05),感染导致外周血白细胞、中性粒细胞、淋巴细胞百分比、血小板等指标较感染前均有下降,但差异无统计学意义(P>0.05)。结论再生障碍性贫血患儿免疫抑制剂治疗期间更易发生医院感染,广谱的抗菌药物联合粒细胞集落刺激因子(G-CSF)的使用可有效地控制感染发生。
OBJECTIVE To investigate the clinical features and related factors of nosocomial infections during immunosuppressive therapy for children with severe aplastic anemia （SAA）. METHODS Seventy-six cases with SAA were treated with immunosuppressive therapy in our Department of Pediatry from Jan 2000 to Aug 2007. Studies about the clinical features and related factors including the infection time, infection sites and the drug treatment have been done on the 76 cases mentioned above during two months since they started immunosuppressive therapy. Changes of peripheral blood were also analyzed after they received antithymocyte globulin （ATG） and got infections. RESULTS The most common infection site was upper respiratory tract, then the oral mucus, lungs, gastrointestinal tract, and the perianal region. Their incidence was respectively 67.3%, 16.3% ,10.2% ,4.1% and 2.1%. There were significant differences in different infection sites （P〈0.05）. The peripheral leukocyte count, lymphocyte ratio and platelet all decreased after SAA children received ATG and got infections and had significant differences compared with before treatment （P〈0. 05）. The above indices and neutrophil were decreased after infection, but without significant differences in comparison with before infection （ P〉0.05 ）. CONCLUSIONS Children with aplastic anemia get nosocomial infection easily during immunosuppressive therapy, but we can control these infections effectively if we use the broad-spectrum antibiotics combined with G-CSF.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第7期946-948,共3页
Chinese Journal of Nosocomiology
基金
广东省自然科学基金项目(2005001686)
广东省社会发展科技攻关计划项目(2006B36005011)
关键词
再生障碍性贫血
儿童
免疫抑制治疗
医院感染
Aplastic anemia
Children
Immunosuppressive therapy
Nosocomial infection
