恶性血液病患者侵袭性真菌感染的影响因素及感染前后肠道菌群结构变化分析

发布时间：2018-05-13 16:51

  本文选题：侵袭性 + 真菌　； 参考：《中华医院感染学杂志》2017年05期

【摘要】：目的探讨恶性血液病侵袭性真菌感染(IFI)的影响因素及真菌感染前后肠道菌群结构的变化情况,为恶性血液病侵袭性真菌感染的诊治提供依据。方法选择医院2010年1月-2015年12月血液科恶性血液病患者1000例,将其中164例IFI患者作为观察组,另选取164例健康者为对照组,采用单因素及多因素logistic分析IFI的影响因素及PCR法检测肠道菌群情况。结果急性白血病和骨髓增生异常综合征、有基础疾病、应用糖皮质激素、抗菌药物应用时间7d、抗菌药物种类2种、白细胞计数≤1.0×109/L者IFI的发生率高于淋巴瘤+慢性白血病+多发性骨髓瘤、无基础疾病、未应用糖皮质激素、抗菌药物应用时间≤7d、抗菌药物种类≤2种、白细胞计数1.0×109/L者(P0.05);应用糖皮质激素、抗菌药物种类2种、白细胞计数≤1.0×109/L是IFI的独立危险因素(P0.05);恶性血液病IFI感染时外周血淋巴细胞、白细胞、中性粒细胞水平(1.13±0.67、7.46±2.14、0.27±0.03)×109/L均明显低于感染前(9.02±1.04、38.24±11.43、3.52±0.86)×109/L(P0.05);观察组感染前和感染时肠道真菌量明显高于对照组(P0.05),观察组感染前和感染时细菌量明显低于对照组(P0.05);观察组感染时真菌量高于感染前(P0.05),观察组感染时细菌量低于感染前(P0.05)。结论应用糖皮质激素、抗菌药物种类2种、白细胞计数≤1.0×109/L是恶性血液病侵袭性真菌感染的独立危险因素,恶性血液病侵袭性真菌感染和肠道真菌量增加、细菌量减少有关。
[Abstract]:Objective to investigate the influencing factors of invasive fungal infection (IFI) in malignant hematopathy and the changes of intestinal flora before and after fungal infection in order to provide evidence for the diagnosis and treatment of invasive fungal infection in malignant hematopathy. Methods 1000 patients with hematologic malignancies were selected from January 2010 to December 2015 in our hospital. 164 patients with IFI were selected as the observation group and the other 1000 healthy persons as the control group. Single factor and multivariate logistic were used to analyze the influencing factors of IFI and PCR method was used to detect intestinal flora. Results Acute leukemia and myelodysplastic syndrome had basic diseases. Glucocorticoids and antibiotics were used for 7 days. The incidence of IFI in patients with leukocyte count 鈮，

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