恶性肿瘤患者合并侵袭性念珠菌感染的预后因素分析

发布时间：2018-05-18 09:54

本文选题：念珠菌 + 侵袭性感染　；参考：《中国肿瘤临床》2017年22期

【摘要】：目的:分析并探讨造成恶性肿瘤患者合并侵袭性念珠菌感染的原因,为改善其预后提供理论依据。方法:回顾性分析2013年12月至2015年12月天津医科大学肿瘤医院发生的侵袭性念珠菌感染的恶性肿瘤患者临床资料,采用Fisher's精确概率法对预后相关因素进行分析,应用Logistic回归分析造成不良预后的独立危险因素。结果:共125例恶性肿瘤患者合并侵袭性念珠菌感染,主要病原菌为白色念珠菌(42.4%),非白色念珠菌中主要为光滑念珠菌(21.6%),近平滑念珠菌(16.8%)及热带念珠菌(10.4%),主要感染部位为腹腔(51.2%);侵袭性念珠菌感染归因病死率为26.4%,氮质血症、体腔置管(≥2根)、抗真菌治疗的延迟及合并细菌性感染是预后不良的独立危险因素,而首次念珠菌培养阳性前30 d内手术则是保护因素。结论:恶性肿瘤患者合并侵袭性念珠菌感染病死率较高,在临床工作中应对相应危险因素积极干预,并及时开展抗真菌治疗,改善预后。
[Abstract]:Objective: to analyze the causes of invasive candida infection in patients with malignant tumors and to provide theoretical basis for improving their prognosis. Methods: the clinical data of malignant tumor patients with invasive Candida infection in Cancer Hospital of Tianjin Medical University from December 2013 to December 2015 were analyzed retrospectively. The prognostic factors were analyzed by Fisher's accurate probability method. Logistic regression analysis was used to analyze the risk factors of poor prognosis. Results: 125 patients with malignant tumor were complicated with invasive Candida infection. The main pathogenic bacteria were Candida albicans 42.4am, while in non-white Candida albicans, Candida lucidum 21.6m, near candida tropicalis 16.8m) and Candida tropicalis 10.4am, the main infection site was 51.22.The mortality of invasive Candida albicans infection was 26.4cm, and the incidence of azotemia was 26.4%. The delayed antifungal therapy and bacterial infection were independent risk factors for poor prognosis, while surgery within 30 days before the first positive culture of Candida was the protective factor. Conclusion: the mortality of malignant tumor patients with invasive Candida infection is high. The risk factors should be actively intervened in clinical work and antifungal therapy should be carried out in time to improve the prognosis.
【作者单位】：天津医科大学肿瘤医院检验科国家肿瘤临床医学研究中心天津市肿瘤防治重点实验室天津市恶性肿瘤临床医学研究中心;
【基金】：国家自然科学基金项目(编号:81302250,81372307) 天津医科大学基金项目(编号:2016KYZQ03)资助~~
【分类号】：R519.3;R730.7

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