79例异基因造血干细胞移植术后患者侵袭性真菌感染的分析

发布时间：2018-11-12 17:42

【摘要】：目的:了解患者行异基因造血干细胞移植术(HSCT)后发生侵袭性真菌感染(IFI)的发病率、危险因素及转归情况。方法:选择我院2005年1月至2014年9月进行HSCT的79例资料较完整的血液病患者的临床资料进行回顾性分析,分析HSCT患者发生IFI的临床特征、危险因素和转归。结果:诊断IFI患者共计17例,其中临床诊断者13例,拟诊4例。感染发生的中位时间为移植后112 d(9-1931 d)。非感染组及感染组的非复发生存率分别为61.2%、35.2%。根据单因素分析:配型、Ⅱ-Ⅳ度a GVHD是发生IFI的危险因素,性别、原发病、感染前使用糖皮质激素的量是患者发生死亡的危险因素。多因素分析显示配型、Ⅱ-Ⅳ度a GVHD是发生IFI的危险因素,感染前使用糖皮质激素量是患者发生死亡的危险因素。结论:具有多种危险因素的患者更易发生IFI,感染前使用较大剂量的免疫抑制剂者更易发生死亡。避免危险因素及回顾患IFI前30 d内使用免疫抑制剂情况可使患者有较好的预后。
[Abstract]:Objective: to investigate the incidence, risk factors and outcome of invasive fungal infection (IFI) after allogeneic hematopoietic stem cell transplantation (HSCT). Methods: the clinical data of 79 patients with HSCT from January 2005 to September 2014 were retrospectively analyzed, and the clinical characteristics, risk factors and outcome of IFI in HSCT patients were analyzed. Results: a total of 17 patients with IFI were diagnosed, of whom 13 were clinically diagnosed and 4 were expected to be diagnosed. The median time of infection was 112d after transplantation (9-1931 d). The non-recurrence survival rate in non-infection group and infection group was 61. 2% and 35. 2%, respectively. According to univariate analysis, type 鈪，

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