恶性血液病合并肺部真菌感染的危险因素分析

Analysis of the risk factors of pulmonary fungal infections related to hematologic malignancies

目的回顾性研究恶性血液病合并肺部真菌感染的危险因素。方法选择自1997年1月～2007年1月在我院诊断恶性血液病合并肺部真菌感染、细菌感染患者,对比分析其相关的危险因素,并进行统计学分析。结果共收集到符合条件的病例304例,其中真菌感染194例,占63.8%,细菌感染110例,占36.2%。单因素分析和Logistic多因素回归分析显示激素、晕轮征、既往真菌感染、ANC小于0.5×109/L持续10d以上、靠近胸膜的结节影、移植(免疫抑制剂使用)、化疗、广谱抗生素是恶性血液病合并肺部真菌感染的独立危险因素。结论恶性血液病合并肺部真菌感染具有多种危险因素,及早发现并及时进行抗真菌干预性治疗是非常必要的。

Objective To investigate the risk factors of pulmonary fungal infections related to hematologic malignancies. Methods A retrospective case-controlled study was conducted to analyze the patients with pulmonary fungal and bacterial infections in association with hematologic malignancies. The risk factors of pulmonary fungal infections related to hematologic malignancies were identified. Results Three hundred and four cases（194 of pulmonary fungal infections and 110 of pulmonary bacterial infections）were enrolled in this study. Univariate analysis and multivariate logistic regression show that such factors as corticosteroid, halo sign,previous fungal infections,ANC lower than 0.5×109/L for over 10 days, nodus near pleura,transplantation （immunodepressant use）, chemotherapy, and broad spectrum antibiotics were all the independent risk factors of pulmonary fungal infections related to hematologic malignancies. Conclusion There are many risk factors for pulmonary fungal infections related to hematologic malignancies, and early identification of these factors for timely antifungal treatment is of much clinical significance.