非霍奇金淋巴瘤化疗后发热感染患者的死亡危险因素分析  

Fatal risk factors for non-Hodgkin lymphoma patients with febrile neutropenia developing infection after chemotherapy

作　　者：欧阳腊梅 汪道峰[1] 方翼[1] 刘啸[1] 李欢[1] 娄宁[1] 

机构地区：[1]中山大学肿瘤防治中心重症医学科,华南肿瘤学国家重点实验室,广东广州510060

出　　处：《中华医院感染学杂志》2016年第20期4654-4656,共3页Chinese Journal of Nosocomiology

基　　金：广东省科技计划基金资助项目(2010B030700051)

摘　　要：目的分析非霍奇金淋巴瘤化疗后发热感染患者的死亡危险因素,为治疗非霍奇金淋巴瘤化疗后发热感染提供临床依据。方法回顾性分析2012年3月-2014年11月住院并接受化疗123例非霍奇金淋巴瘤发热感染患者临床资料,对患者的年龄、性别、肿瘤分期等进行单因素分析,在此基础上选择有意义的变量进行多因素非条件logistic回归分析,从而得出非霍奇金淋巴瘤化疗后发热感染患者死亡的独立危险因素。结果 123例非霍奇金淋巴瘤发热感染患者,总体住院死亡23例,死亡率为18.7%;单因素分析显示,转入ICU治疗、降钙素原(PCT)>2ng/ml、Ⅳ度骨髓抑制天数>10d、多部位感染的非霍奇金淋巴瘤化疗后发热感染患者的住院死亡率较高,多因素非条件logistic回归分析显示,PCT>2ng/ml、Ⅳ度骨髓抑制天数>10d是非霍奇金淋巴瘤化疗后发热感染患者死亡的独立危险因素。结论非霍奇金淋巴瘤化疗后发热感染患者有较高的住院死亡率,早期诊断感染及积极治疗骨髓抑制可能有助于提高非霍奇金淋巴瘤化疗后发热感染患者的生存。OBJECTIVE To analyze the fatal risk factors for non-Hodgkin lymphoma （NHL） patients with febrile neutropenia developing infection after chemotherapy, so as to provide clinical evidence for treating NHL patients with febrile neutropenia after chemotherapy. METHODS A total of 123 NHL patients with febrile neutropenia who were hospitalized and received chemotherapy at the SUN Yat-sen University Cancer Center from Mar. 2012 to Nov. 2014 were retrospectively analyzed. Through querying the electronic medical records, clinical data of age, gender, tumor staging and so on were collected. Univariate analysis was done to analyze all the risk factors, and significant variables were selected and used in multivariate and unconditioned logistic regression analysis, in order to obtain the independent fatal risk factors for NHL patients with febrile neutropenia developing infection after chemotherapy. RESULTS The overall intra-hospital mortality was 18. 7% （23 cases）, For univariate analysis, there were significant differences in the mortality rates according to ICU admission, PCT（procalcitonin）〉 2ng/ ml, duration of grade Ⅳ myelosuppression 〉10 days, and multi-site hospital infection. In multivariate and un- conditioned logistics regression analysis, PCT ~ 2ng/ml and duration of grade IV myelosuppression 〉 10 days were the independent fatal risk factors for NHL patients with febrile neutropenia developing infection after chemo- therapy. CONCLUSION NHL patients with febrile neutropenia developing infection after chemotherapy have high intra-hospital mortality, and the early diagnosis of infection and actively treating bone marrow suppression could have contributed to improve the survival of such patients.

关 键 词：非霍奇金淋巴瘤 发热性中性粒细胞减少症 感染 死亡危险因素 

分 类 号：R733[医药卫生—肿瘤]