9例成人急性白血病并发念珠菌败血症临床分析  

Clinical study on 9 cases of adult acute leukemia with candidemia

作　　者：刘小云[1] 张扣兴[1] 肖若芝[1] 林东军[1] 张永标[1] 方志刚[1] LIU Xiao-yun ZHANG Kou-xing XIAO Ruo-zhi LIN Dong-jun ZHANG Yong-biao FANG Zhi-gang(The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou , Guangdong 510630, China)

机构地区：[1]中山大学附属第三医院,广东广州510630

出　　处：《热带医学杂志》2017年第8期1082-1085,共4页Journal of Tropical Medicine

摘　　要：目的分析急性白血病并发念珠菌败血症的临床特征,探讨其早期死亡的危险因素。方法选取中山大学附属第三医院血液内科诊治的9例急性白血病并发念珠菌败血症患者,并根据转归分为存活组与死亡组,对临床资料进行回顾性分析。结果存活组发热前粒细胞缺乏时间短于死亡组,差异有统计学意义(P=0.046);存活组与死亡组降钙素原(PCT)、C-反应蛋白最高值(CRP-MAX)、降钙素原最高值(PCT-MAX)、1,3-β-D葡聚糖(BDG)-MAX差异有统计学意义(P=0.004、0.008、0.005、0.015),在临床表现、真菌预防与否、治疗方法、C-反应蛋白(CRP)、红细胞沉降率(ESR)、红细胞沉降率最高值(ESR-MAX)、BDG之间的差异无统计学意义(P>0.05)。结论更长时间的粒细胞缺乏后出现念珠菌败血症、白色念珠菌感染、更高的PCT、PCT-MAX、CRP-MAX及BDG-MAX等是念珠菌败血症的不良预后因素。Objective To analyze the clinical features and explore the risk factors of early death of acute leukemia patients complicated with candidemia. Methods We retrospectively analyzed the clinical data of 9 patients with acute leukemia complicated with candidemia who was diagnosed and treated in department of Hemopathology in the Third affiliated Hospital of Sun Yat-sen University and those patients were divided into survival group and death group according to their outcome. Results The time of neutropenia before fever of survival group shorter than death group （P=0.046）.The differences of procalcitonin （PCT） , the maximum of C - reactive protein （CRP- MAX） , the maximum of PCT （PCT- MAX） and the maximum of 1, 3-13-D glucan （BDG-MAX） between survival group and death group were statistically significant （P= 0.004, 0.008, 0.005, 0.015）. There were no statistical significant differences in clinical manifestations, fungi prevention, treatment methods, C-reactive protein （CRP）, erythrocyte sedimentation rate （ESR）, the maximum of ESR （ESR-MAX） and BDG between survival group and death group （P〉0.05）. Conclusion The longer time of neutropenia before Candida septicaemia, Candida albicans infection and higher PCT, PCT-MAX, CRP-MAX, BDG-MAX were poor prognostic factors of candidemia.

关 键 词：急性白血病 念珠菌 败血症 

分 类 号：R733.71[医药卫生—肿瘤]