高危急性淋巴细胞白血病患者维持治疗阶段营养状况与医院感染发生率的相关性研究  

Relationship between nutritional status and incidence of nosocomial infection in patients with high risk acute lymphoblastic leukemia

作　　者：宁方颖[1] 蓝建平[1] 陈一瑞[1] 解鸿翔[2] NING Fang-ying LAN Jian-ping CHEN Yi-rui et al(Department of Hematology,Zhefiang Provin- cial People＇ s Hospital, Hangzhou, Zhejiang 310006, China)

机构地区：[1]浙江省人民医院血液内科,浙江杭州310006 [2]浙江省人民医院检验科

出　　处：《中华全科医学》2017年第9期1582-1585,共4页Chinese Journal of General Practice

基　　金：浙江省自然科学基金项目(LQ16H080001)

摘　　要：目的探讨高危急性淋巴细胞白血病患者维持治疗阶段营养状况与医院感染发生率的相关性研究。方法使用自行设计的调查问卷收集2013年1月—2016年6月浙江省人民医院收治的286例高危急性淋巴细胞白血病患者相关资料,采用患者主观整体评估(PG-SGA)法评估患者维持治疗阶段的营养状况,分析患者营养状况与医院感染发生率的相关性。结果 286例高危急性淋巴白血病患者中不需要营养支持104例,需要营养支持182例,其中有98例发生医院感染,占34.27%(98/286);急性淋巴细胞白血病患者医院感染发生率与营养状况呈负相关(r=-0.724,P<0.001);单因素分析显示,住院时间、化疗强度、血红蛋白、白细胞计数、中性粒细胞、抗生素应用种类、白蛋白、抗生素使用时间、PG-SGA评分等差异有统计学意义(P<0.05),年龄、性别、糖皮质激素使用等差异无统计学意义(P>0.05);Logistic多因素回归分析显示:PG-SGA评分、化疗强度、中性粒细胞数、血红蛋白、白蛋白、抗生素使用时间等是高危急性淋巴细胞白血病患者医院感染发生的影响因素。结论高危急性淋巴细胞白血病患者维持治疗阶段的营养状况与医院感染发生率密切相关,患者营养状况是发生医院感染的危险因素。Objective To investigate the relationship between nutritional status and the incidence of nosoconfial infection in patients with high risk acute lymphoblastic leukemia. Methods A self-designed questionnaire was used to collect rele- vant data of 286 cases of high risk patients with acute lymphoblastic leukemia in , Zhejiang Provincial People＇s Hospital from January,2013 to June,2016. Subjective global assessment（PG-SGA） method was used to evaluate the nutritional sta- tus of patients with maintenance treatment phase, analysis of the infection rate of correlation between nutritional status and hospital patients. Results Two hundred and eighty-six cases of high-risk acute lymphoblastic leukemia patients do not need nutritional support in 104 cases, the need for nutritional support in 182 cases, including 98 cases of hospital infec- tion, accounting for 34.27% （ 98/286 ） in patients with acute lymphoblastic leukemia ; hospital infection rate and nutrition- al status were negatively correlated （ r = - 0. 724, P 〈 0.01 ） ; Univariate analysis showed that significant length of time, the intensity of chemotherapy, hemoglobin,leukocyte count, neutrophils, species, application of antibiotics, antibiotic use time, albumin PG-SGA score difference （ P 〈 0.05 ）. There was no significant difference in age, sex, glucocorticoid use （ P 〉 0.05 ）. Logistic regression analysis showed that the PG-SGA score,the intensity of chemotherapy,neutrophil count,hemo- globin, albumin, antibiotic use time are the risk factors of nosocomial infection in patients with high-risk acute lymphoblas- tic leukemia. Conclusion The nutritional status of high risk acute lymphoblastic leukemia patients is closely related to tbe incidence of nosocomial infection and the nutritional status of the patients is a risk factor for the occurrence of hospital infection.

关 键 词：急性淋巴细胞白血病 维持治疗阶段 营养状况 医院感染发生率 

分 类 号：R557.4[医药卫生—血液循环系统疾病] R459.3[医药卫生—内科学]