摘要
目的探讨急性白血病(AL)合并血流感染患者死亡的危险因素。方法收集2013年4月至2017年3月在郑州大学第一附属医院血液科住院的200例AL合并血流感染患者的临床资料,根据治疗30 d后患者的生存情况分为死亡组(44例)和生存组(156例)。比较两组患者临床资料,并分析患者死亡的危险因素。结果初治AL、复发后再次诱导AL、诱导化疗期AL、应用糖皮质激素、中性粒细胞缺乏、感染性休克、不合适初始抗感染治疗与AL合并血流感染患者30 d内死亡相关(P<0.05)。多因素分析显示,感染性休克(95%CI:3.240~22.052,P<0.05)及不合适初始抗感染治疗(95%CI:2.151~13.367,P<0.05)是AL合并血流感染患者死亡的独立危险因素。结论感染性休克及不合适初始抗感染治疗的AL合并血流感染患者死亡率高,应合理应用抗感染治疗,以改善患者预后。
Objective To investigate the risk factors of death in patients with acute leukemia （AL） complicated with bloodstream infection. Methods The clinical data of 200 patients treated in the department of hematology of the First Affiliated Hospital of Zhengzhou University from April of 2013 to March of 2017 were collected. The patients were divided into death group （44 cases） and survival group （156 cases） according to the survival of patients after treatment for 30 days. The clinical data of two groups were compared and the risk factors of death were analyzed. Results The initial treatment of AL, relapse after induction of AL, induced chemotherapy of AL, application of glucocorticoid, neutropenia, septic shock, inappropriate initial anti-infective treatment were associated with 30-day mortality in patients with AL complicated with bloodstream infections（ P 〈0.05 ）. Multivariate analysis showed that septic shock （95% CI ： 3.240-22.052, P 〈0.05 ） and inappropriate initial anti-infective therapy （95% CI ： 2.151-13.367, P 〈0.05） were independent risk factors of death in AL patients complicated with bloodstream infections. Conclusion Septic shock and inappropriate initial anti-infective treatment result in high mortality in patients with AL and bloodstream infections, and anti-infective therapy should be rationalized to improve the prognosis of patients.
作者
李亚雨
马杰
胡营涛
李宁
仵菲斐
谢新生
孙慧
Li Yayu;Ma Jie;Hu Yingtao;Li Ning;Wu Feifei;Xie Xinsheng;Sun Hui(Department of Hematology,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Chin)
出处
《河南医学研究》
CAS
2018年第10期1737-1739,共3页
Henan Medical Research
基金
国家自然科学基金(81000224)
关键词
白血病
血流感染
临床特征
死亡
危险因素
leukemia；bloodstream infections；clinical features；death；risk factor
