亚胺培南治疗急性白血病感染患者的效果研究  

Clinical effect of imipenem on treatment of infections in patients with acute leukemia

作　　者：陈晓峰 潘迎英 冯高华 

机构地区：[1]张家港市中医医院药学部,江苏张家港215600 [2]张家港市中医医院血液科,江苏张家港215600 [3]张家港市中医医院呼吸科,江苏张家港215600

出　　处：《中华医院感染学杂志》2014年第22期5532-5534,共3页Chinese Journal of Nosocomiology

基　　金：江苏省预防医学基金资助项目(Y2012077)

摘　　要：目的探讨导致急性白血病(AL)感染的危险因素及亚胺培南对其治疗的临床效果,为临床治疗和预防AL患者医院感染的发生提供参考依据。方法回顾性分析2010年1月-2012年9月78例AL患者临床资料,对78例AL患者采用单因素分析和多因素logistic回归分析探讨感染的危险因素;对36例感染患者根据治疗方法将其分为A、B两组,A组20例患者感染初立即应用亚胺培南,B组16例患者先用其他抗菌药物后改用亚胺培南,对两组患者治疗效果进行对比分析,采用SPSS16.0统计软件进行数据统计分析。结果对78例AL患者感染36例,感染率为46.15%,治疗总有效率A组为95.00%,B组为93.75%,两组间比较差异无统计学意义;A组抗菌药物使用时间(11.8±3.8)d、起效时间(5.4±2.7)d,B组分别为(15.7±5.4)d、(8.1±3.3)d,两组间比较差异有统计学意义(P<0.05);单因素分析显示,年龄>9岁、中性粒细胞数值≤2×109/L、近期有感染、住院时间>30d、住院在春冬季、输血>9次和抗菌药物的使用是发生感染的相关因素(P<0.05);多因素logistic回归分析结果显示,年龄>9岁、中性粒细胞数值≤2×109/L、近期有感染、住院时间>30d和住院在春冬季是AL患者发生感染的独立危险因素。结论多种因素是导致AL患者发生感染的危险因素,应根据感染的危险因素采用针对性的预防措施,正确的经验性抗菌药物治疗可提高患者临床治疗有效率。OBJECTIVE To explore the risk factors for infections in the patients with acute leukemia （AL） and ob‐serve the clinical effect of imipenem on treatment of the infections so as provide guidance for clinical prevention and treatment of nosocomial infections in the AL patients .METHODS The clinical data of 78 AL patients who were treated in the hospital from Jan 2010 to Sep 2012 were retrospectively analyzed ,then the univariate analysis and multivariate logistic regression analysis were performed for the risk factors for infections in the 78 AL patients ;totally 36 patients with infections were divided into the group A and the group B according to the treatment meth‐ods ,the group A with 20 patients was treated with imipenem since the initial stage of onset of infections ,the group B with 16 cases was firstly given other antibiotics then treated withimipenem ;the therapeutic effect was ob‐served and compared between the two groups ,and the statistical analysis was performed by means of SPSS16 .0 software .RESULTS Of the 78 AL patients ,36 cases were infected with the infection rate of 46 .15% .The total ef‐fective rate of treatment was 95 .00% in the group A ,93 .75% in the group B ,there was no statistically significant difference .The time of use of antibiotics was （11 .8 ± 3 .8） days in the group A ,（15 .7 ± 5 .4）days in the group B ;the onset time was （5 .4 ± 2 .7）days in the group A ,（8 .1 ± 3 .3）days in the group B ,and there were statistically significant differences between the two groups （P〈0 .05） .The univariate analysis showed that the more than 9 years of age ,neutrophil cells counts no more than 2 × 109/L ,recent infections ,length of hospital stay more than 30 days ,hospital stay in spring and winter ,more than 9 times of blood transfusion ,and use of antibiotics were the related factors for the infections （P〈0 .05） .The multivariate logistic regression analysis indicated that the more than 9 years of age ,neutrophil cells counts no more than 2 × 109/L ,re

关 键 词：急性白血病 感染 亚胺培南 危险因素 治疗效果 

分 类 号：R978.1[医药卫生—药品]