血液病患者血小板计数与院内感染发生的关系研究

Relationship between the platelet counts and nosocomial infection in patients with hematologic disease

目的探讨血液科患者外周血血小板(PLT)计数与发生院内感染的关系。方法共纳入发生院内感染的血液科患者311例,测定其外周血PLT计数,结合细菌学检测结果,分析血液病患者PLT计数与院内感染发生的关系。结果血液科总感染率为9.27%,在分离出的311株病原菌中,革兰阴性菌200株(64.3%),革兰阳性菌88株(28.3%),真菌23株(7.4%)。感染部位主要集中在呼吸道和血液,两者共占89.4%,其中肺部感染117例(37.6%),血液感染81例(26.0%),鼻咽部感染80例(25.7%)。感染组的PLT值明显低于无感染组和总体标本(P=0),并且随着PLT值的增高,感染率随之下降。咽部黏膜感染患者和血液感染患者PLT值明显低于肺部感染患者,也低于总体水平,差异有统计学意义(P<0.05)。结论 PLT计数在血液科患者院内感染中有着重要的临床意义,可以作为是否采取感染预防措施以及决定重点预防部位的参考。

Objective To investigate the relationship between platelet counts and nosocomial infection in patients with hemato- logic disease. Methods Parameters of PLT in 311 nosocomial infected patients with hematologic disease were analyzed retrospec- tively. The relationship between the platelet counts and nosocomial infection was observed. Results The total infection rate of he matologic disease in patients was 9.27 %. A total of 311 pathogens were isolated by bacterial culture, in which the major pathogenic bacteria were the Gram negative bacilli （200 strains, 64.3 %） ,the Gram positive bacteria were 28.3 % （88 strains） and fungi were 7.4 % （23 strains）. The most common infection included pulmonary infection （117cases, 37. 6%）, blood infection （81 cases, 26.0 % ）, and nasopharyngeal infection （80 cases, 25.7 % ）. The platelet count of infected group was significantly lower than that in the nominfected group and the overall level （both P=0）. In addition,the platelet count was inversely proportional to the infection rate. The platelet counts of patients with pharyngeal mucosal infection and blood infection were also significantly lower than that in the patients with lung infection and the overall level （both P〈0.05）. Conclusion The platelet count could be considered as a useful factor for infection prevention in patients with hematologic disease,who undergo nosocomial infection.