恶性血液病患者肠源性败血症的危险因素研究

Risk factors for gut-derived sepsis in patients with hematologic malignancies

目的探讨恶性血液病患者化疗后肠源性败血症的危险因素。方法对肠源性败血症患者采用病例对照研究方法,进行单因素和多因素logistic分析。结果恶性血液病患者化疗后使用质子泵抑制剂(PPI)的比未使用的肠源性败血症发生率(82.4%)高(P=0.000);而糖尿病、病毒性肝炎、糖皮质激素治疗、粒细胞缺乏时间、抗菌药物使用两组之间比较,差异无统计学意义;单因素研究发现,仅PPI的使用差异有统计学意义(OR=0.343,P=0.485);多因素研究发现,PPI的使用是肠源性败血症的独立危险因素(P=0.00,r=0.485)。结论 PPI的使用与恶性血液病患者化疗后肠源性败血症有关。

OBJECTIVE To explore the risk factors for gut-derived sepsis in patients with hematologic malignancies after chemotherapy. METHODS A retrospective case-control study was performed. The data were analyzed by monovariate and multivariate logistic regression analysis. RESULTS Higher incidence of gut-derived sepsis （82.40%） was found in the patients with hematologic malignancies who used PPI after chemotherapy than in those who did not use PPI （P=0. 000）. The differences in diabetes, viral hepatitis, gtucocorticoid treatment, duration of agranulocytosis, and the use of antibiotics between the two groups were not statistically significant; univariate analysis showed that only the difference in use of PPI has statistical significance （OR = O. 343, P = 0. 485）. Multivariate analysis demonstrated that the use of PPI was the independent factor for gut-derived sepsis （P=0.00,r= 0. 485）. CONCLUSION The use of PPI is associated with gut-derived sepsis in patients with hematologic malignancies after chemotherapy.