真菌感染与白细胞相关因素研究

Fungus Infection and Differential Leukocyte Count: Relation Between Them

目的探讨真菌感染与白细胞、发热、死亡率之间的关系,有助于提高对真菌感染的临床诊断和治疗水平。方法将真菌感染患者141例分深部败血症、肺部、胆道,中枢神经、局部生殖泌尿道、肠道和对照组进行白细胞计数和分类,发热、死亡率进行统计分析。结果深部真菌感染念珠菌属和隐球菌属、曲霉菌属占90.8%,曲霉菌属感染引起患者高死亡率可达88.9%;真菌引起的血液系统、胆道、深部感染所致发热率可达100%,而局部生殖泌尿、肠道感染、神经系统则表现不一;深部肺曲霉、青霉菌感染引起患者WBC总数和分类均显著高于正常对照(P<0.01);而念珠菌属酵母样真菌引起的深部和局部感染所致白细胞总数与正常对照人群差异无显著性(P>0.05)。结论深部真菌感染组患者发热比率显著高于神经系统、生殖泌尿、肠道局部感染患者;深部酵母菌感染其白细胞总数在正常范围内波动,而侵袭性肺曲霉菌感染患者白细胞显著增高;系统性念珠菌病、新型隐球菌病和侵袭性曲霉菌病是当前三大机会性感染真菌。

OBJECTIVE To discuss the relation between the fungal infection and differential leukocyte count, fever and death rate, for progressing clinical diagnosis and therapy in fungal infection. METHODS The patients were divided into septicemia groups,lung infection groups,biliary tract infection groups, nerve center and local urinary tract groups, intestinal tract groups, and normal control groups. And the differential leukocyte count, and fever and death rate were analyzed. RESULTS The Aspergillus, Candida and Cryptococcus were occupied 90.8% for deep fungal infection, and the Aspergillus caused patients death rate to 88. 9% fungal infection for septicemia, lungs,biliary tract caused patients fever rate was to 100%, but urinary tract, intestinal tract and nerve center behaved variously. For lungs the Aspergillus and Penicillium caused differential leukocyte WBC count had high than the control signficant difference , P〈0. 01, but yeast for deep and local infection was not, P〉0.05. CONCLUSIONS The deep fungal infection caused higher patients fever rate, and the Aspergillus and Penicillium caused higher differential leukocyte count, but deep and local yeast was not. Currently the Aspergillus, Candida and Cryptococcus are three main opportunistic infected fungi.