恶性血液系统疾病粒缺期继发念珠菌血症的预后相关因素分析  

Candidemia secondary to malignant hematologic disease with neutropeina:a clinical retrospective analysis of 51 cases

作　　者：张隽瑜[1] 李琳洁[1] 黄河[2] 蔡真[2] 吴文俊[2] 

机构地区：[1]丽水市中心医院,浙江丽水323000 [2]浙江大学医学院附属第一医院,浙江杭州310003

出　　处：《浙江医学教育》2018年第1期61-63,共3页Zhejiang Medical Education

摘　　要：目的:了解恶性血液系统疾病粒缺期继发念珠菌血症的发病率、高危因素及临床预后。方法:收集3家医院恶性血液系统疾病粒细胞缺乏期继发的51例念珠菌血症临床资料。采用t检验进行预后单因素分析,采用多元Logistic回归进行预后多因素分析。结果:血培养共培养出58株念珠菌,有7例先后培养出2种念珠菌。多因素分析显示,合并细菌血流感染、肾功能异常为患者归因病死率增高的独立危险因素。结论:恶性血液系统疾病粒缺继发念珠菌血症病原菌种主要以热带念珠菌为主;合并细菌血流感染、肾功能异常与归因病死率相关。[Objective]To elucidate the high risk factors,the independent factors associated with the mortality,clinical prognoses,and candida species distributional characteristics of candidemia secondary to malignant hematologic disease with neutropeina. [Method]The data of 51 cases of candidemia secondary to malignant hematologic disease with neutropeina were collected. The t-test and multivariate logistic regression analysis was performed. [Result]Fifty-eight Candida strains were cultured during the blood culture and 2 species were observed in the blood culture of 7 cases. The prognostic multivariate logistic analysis indicated that the independent factors associated with the attributable mortality increase included the complication of bloodstream bacterial infection and abnormal renal creatinine level. The main pathogenic species in the 51 patients was Candida tropicalis. The complication of bloodstream bacterial infection was associated with the attributable mortality increase. The ex vivo drug susceptibility test indicated that the drug resistance rate of triazoles was higher than that of amphotericin B and echinocandins. [Conclusions]Candida tropicalis is the main pathogens of secondary candidosis in malignant hematologic diseases.Combined with bacterial bloodstream infection,abnormal renal function is associated with at-risk of death.

关 键 词：念珠菌血症 危险因素 

分 类 号：R557.3[医药卫生—血液循环系统疾病]