造血干细胞移植后患者口腔真菌感染的危险因素分析  

Risk factors for oral fungal infections after hematopoietic stem cell transplantation

作　　者：马静玲[1] 郑锦萍[1] 梁小艳[1] 许多荣[1] 

机构地区：[1]广州市中山大学附属第一医院血液内科二区,广东广州510080

出　　处：《中华医院感染学杂志》2014年第5期1176-1177,1180,共3页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81370663);广东科技计划基金项目(2011B031800120)

摘　　要：目的探讨造血干细胞移植术后患者发生口腔真菌感染的情况,并对易引发口腔真菌感染的危险因素进行分析。方法回顾性分析2008年1月-2013年1月医院接受造血干细胞移植的102例患者临床资料,单因素分析法找出差异有统计学意义的因素,并对其进行非条件logistic回归分析,找出导致造血干细胞移植后患者发生口腔真菌感染的独立危险因素。结果接受造血干细胞移植后发生口腔真菌感染患者共计49例,发生率为48.04%;分离出真菌52株,主要为白色假丝酵母菌39株占75.00%,马尔尼菲青霉菌6株占11.54%,其余为圆弧青霉菌4株占7.69%、热带假丝酵母菌2株占3.95%以及克柔假丝酵母菌1株占1.92%;危险因素分析结果显示,免疫力低下(β=0.962,OR=2.721)、漱口液应用不当(β=1.978,OR=5.980)、贫血(β=2.287,OR=7.606)、移植前大剂量放化疗(β=2.149,OR=6.811)是造血干细胞移植患者术后发生口腔真菌感染的危险因素。结论应对容易引发造血干细胞移植后口腔真菌感染的各种危险因素加以预防,尽量降低造血干细胞移植后口腔真菌感染的发生率,减轻患者痛苦。OBJECTIVE To observe the incidence of oral fungal infection in the patients after hematopoietic stem cell transplantation and analyze the risk factors for the oral fungal infection. METHODS The clinical data of 102 patients who received the hematopoietic stem cell transplantation in the hospital from Jan 2008 to Jan 2013 were retrospectively analyzed, then the univariate analysis was performed to screen out the factors that had statistical significance, and the non-conditional logistic regression analysis was conducted to find out the independent risk factors for the oral fungal infection. RESULTS Of the patients who received the hematopoietic stem cell transplantation, the oral fungal infections occurred in 49 cases with the incidence rate of 48. 04%. A total of 52 strains of fungi were isolated, including 39 （75.00%） strains of Candida albicans , 6 （11. 54%） strains of Penicilliummarnef fei, 4 （7.69%） strainsofPenicilliumcyciopium, 2 （3.95%） strains of Candida tropical is, and 1 （1. 92%） strain of Candida krusei. The analysis of the risk factors indicated that the low immunity （β= 0.962, OR= 2. 721）, improper application of mouthwashes （β= 1. 978, OR = 5. 980）, anemia （β= 2. 287, OR= 7. 606）, and high-dose chemotherapy before transplantation （β= 2. 149, OR = 6. 811） were the risk factors for the postoperative oral fungal , infections in the patients undergoing the hematopoietic stem cell transplantation. CONCLUSION It is necessary to prevent the risk factors for the oral fungal infection after the hematopoietic stem cell transplantation and try to reduce the incidence of the oral fungal infection so as to alleviate the patients pain.

关 键 词：造血干细胞移植 口腔 真菌感染 危险因素 

分 类 号：R181.32[医药卫生—流行病学]