卵巢癌化疗感染危险因素及卵巢癌化疗耐药机制研究  

A study on the risk factors of chemotherapy infection in ovarian cancer and the mechanism of chemotherapy resistance in ovarian cancer

作　　者：刘海凤 王静依 韩素彬 李文 黄彬彬 LIU Haifeng;WANG Jingyi;HAN Subin;LI Wen;HUANG Shanshan(The Second Affiliated Host of Chengdu Medical College China National Nuclear Corporation 416 Hospital,Chengdu 610000,China)

机构地区：[1]成都医学院第二附属医院核工业四一六医院,四川成都610000

出　　处：《中国病原生物学杂志》2024年第6期671-674,679,共5页Journal of Pathogen Biology

基　　金：成都市卫健委课题(No.2021226)。

摘　　要：目的分析卵巢癌化疗患者感染相关危险因素及卵巢癌化疗耐药机制。方法选取本院收治的418例卵巢癌化疗患者为本次研究对象。院内电子病例系统查询患者临床资料,对比分析化疗合并感染与未感染患者临床资料,分析卵巢癌化疗感染的相关危险因素。采集感染患者感染部位多种分泌物标本,细菌培养后,采用全自动微生物鉴定分析系统鉴定菌种。将并发感染患者根据化疗耐药,分为铂耐药与铂敏感组,对比两组患者血脂水平。结果418例卵巢癌化疗患者中,42例并发感染,感染率为10.05%(42/418)。感染部位主要为上呼吸道与下呼吸道,其次为消化道、泌尿道、皮肤和软组织、导管相关、手术部位、器官腔隙、血液系统及其他部位。共检出病原菌42株,其中革兰阴性菌26株,革兰阳性菌11株,真菌5株。革兰阴性菌主要为肺炎克雷伯菌(30.95%,13/42)。革兰阳性菌主要为肺炎链球菌(9.52%,4/42)。真菌主要为白色假丝酵母菌(7.14%,3/42)。对比化疗并发感染与未感染患者临床资料,单因素分析显示,年龄、营养指数评分、合并糖尿病、留置导尿管时间、住院时间、化疗周期差异有统计学意义(P<0.05),临床分期差异无统计学意义(P>0.05)。多因素分析显示,年龄≥65岁、营养指数评分≥4分、合并糖尿病、留置导尿管时间≥7 d、住院时间≥14 d、化疗周期≥5个,是卵巢癌化疗并发感染的独立危险因素(P<0.05)。铂耐药组患者血清低密度脂蛋白、高密度脂蛋白、胆固醇、甘油三酯水平分别为(3.37±0.78)mmol/L、(1.33±0.42)mmol/L、(5.54±1.00)mmol/L、(1.77±0.68)mmol/L,铂敏感组患者血清低密度脂蛋白、高密度脂蛋白、胆固醇、甘油三酯水平分别为(2.85±0.65)mmol/L、(1.48±0.36)mmol/L、(4.93±0.72)mmol/L、(1.36±0.56)mmol/L。两组患者血清低密度脂蛋白、胆固醇、甘油三酯水平差异有统计学意义(P<0.05),血清高密度脂蛋白�Objective To analyze the risk factors related to infection in ovarian cancer chemotherapy patients and the mechanism of ovarian cancer chemotherapy resistance.Methods 418 ovarian cancer chemotherapy patients admitted to our hospital were selected as the subjects of this study.By querying patient clinical data through the hospital's electronic case system,the clinical data of patients with concurrent chemotherapy infection and those without infection were compared and analyzed,and the relevant risk factors for chemotherapy infection in ovarian cancer were analyzed.The samples of various secretions from infected patients were collected at the site of infection,and after bacterial culture,bacterial were identified by a fully automated microbial identification and analysis system.Patients with concurrent infections were divided into platinum resistant and platinum sensitive groups based on chemotherapy resistance,and their blood fat levels were compared between the two groups.Results Among 418 ovarian cancer chemotherapy patients,42 cases developed concurrent infections,with an infection rate of 10.05%(42/418).The main sites of infection were the upper and lower respiratory tracts,followed by the digestive tract,urinary tract,skin and soft tissue,catheter-related areas,surgical sites,organ cavities,blood system,and other parts.A total of 42 pathogenic bacteria were detected,including 26 Gram negative bacteria,11 Gram positive bacteria,and 5 fungi.Gram negative bacteria were mainly Klebsiella pneumoniae(30.95%,13/42).The main Gram positive bacteria were Streptococcus pneumoniae(9.52%,4/42).The main fungus was Candida albicans(7.14%,3/42).The clinical data of patients with chemotherapy complicated with infection and those without infection were compared.Single factor analysis showed that there were statistically significant differences in age,nutrition index score,diabetes complicated with infection,indwelling catheter time,hospital stay,and chemotherapy cycle(P<0.05),while there were no statistically significant diffe

关 键 词：卵巢癌 化疗 感染 危险因素 化疗耐药 

分 类 号：R737.31[医药卫生—肿瘤]