老年急性白血病患者侵袭性真菌病临床特征

发布时间：2018-08-30 18:18

【摘要】：目的分析老年急性白血病(AL)患者发生侵袭性真菌病(IFD)的临床特征。方法回顾分析2014年1~12月吉林大学第一医院肿瘤中心收治的老年AL患者IFD的发生情况,分析其临床特征、高危因素、疗效及对预后的影响。结果筛选25例接受系统治疗的老年AL患者,共治疗80例次,人均IFD发生率与同期非老年AL患者比较差异无统计学意义〔44%(11/25)vs 28.67%(43/150),P0.05〕,但每疗程IFD发生率显著高于同期非老年AL患者〔16.25%(13/80)vs 7.41%(56/756),P=0.010〕。诱导治疗阶段IFD发生率高于巩固治疗阶段〔37.04%(10/27)vs5.66%(3/53),P=0.001〕。前期应用广谱抗生素(92.3%)及粒细胞缺乏(84.6%)是主要危险因素。初始治疗有效率为61.54%,除外急性早幼粒细胞白血病(APL),发生IFD的老年AL患者较非老年IFD组中位生存期显著缩短(4.5个月vs 17.5个月,P=0.002)。结论老年AL患者IFD发生率高且对预后有不良影响。
[Abstract]:Objective to analyze the clinical features of invasive mycosis (IFD) in elderly patients with acute leukemia (AL). Methods the incidence of IFD in elderly AL patients treated in the tumor center of the first Hospital of Jilin University from January to December 2014 was analyzed retrospectively. The clinical characteristics, high risk factors, curative effect and influence on prognosis were analyzed. Results there were 80 times of systematic therapy in 25 elderly AL patients. There was no significant difference between the incidence of IFD per capita and that of non-elderly AL patients (44% (11 / 25) vs 28.67% (43 / 150) P 0.05). But the incidence of IFD per course of treatment was significantly higher than that in non-elderly AL patients (16.25% (13 / 80) vs 7.41% (56 / 756) P0. 010). The incidence of IFD in induction therapy stage was higher than that in consolidation therapy stage (37.04% (10 / 27) vs5.66% (3 / 53) P0. 001). The main risk factors were broad-spectrum antibiotics (92.3%) and granulocyte deficiency (84.6%). The effective rate of initial treatment was 61.54. The median survival time of elderly AL patients with IFD except acute promyelocytic leukemia (AHL) (APL), was significantly shorter than that of non-elderly IFD patients (4.5 months vs 17.5 months P0. 002). Conclusion the incidence of IFD in elderly patients with AL is high and the prognosis is bad.
【作者单位】：吉林大学第一医院肿瘤中心血液科;长春医学高等专科学校临床医学部内科教研室;
【基金】：吉林省卫生科研计划(2013z086)
【分类号】：R733.71;R519

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