白血病患者血液感染危险因素研究

Risk Factors of Infection in Leukemia Patients Hemodialysis: A 1∶1 Matched Case -control Study

目的 探讨白血病患者血液感染的危险因素。方法 对医院住院白血病患者发生血液感染者进行 1∶ 1配对病例对照研究。结果 单因素卡方分析发现住院时间超过 30 d、不合理使用抗生素、动静脉插管、贫血、白细胞数 <4× 10 9/ L、输血等 6个因素与白血病患者血液感染有关联 ;条件 L ogistic多元回归模型分析表明动静脉插管、输血、白细胞数 <4× 10 9/ L 和住院时间 >30 d是引起白血病患者血液感染的主要危险因素 ;而且趋势 χ2分析发现 ,白细胞数越低、输血次数越多、输血量越大、住院时间越长 ,患者发生血液感染的风险就越大。结论 减少侵入性操作、安全输血和积极提高白细胞数对预防和控制白血病患者血液感染有十分重要的意义。

OBJECTIVE To explore the risk factors for infection of hemodialysis in leukemia patients. METHODS A 1∶1 matched case control study with 52 pairs on risk factors of infection of hemodialysis in leukemia patients was carried out in Fuzhou city in 1999. The available data were analyzed by Chi square test and multiple Logistic regression model. RESULTS Chi square test showed that infection of hemodialysis was significantly associated with long term hospitalization, leukopenia (WBC was below 4×10 9/L), anemia, arteriovenous catheter, blood transfusion, unsuitable application of antibiotics. The multivariable conditional Logistic regression analysis showed that infection of hemodialysis was significantly associated with long term hospitalization (with OR of 14.7, P<0.001), arteriovenous catheter (with OR of 11.7, P<0.01), blood transfusion (with OR of 12.0, P<0.01), leukopenia (WBC was below 4×10 9/L, with OR of 2.9, P<0.05). CONCLUSIONS It suggests that occurrence of infection of hemodialysis correlate to long term hospitalization, arteriovenous catheter, blood transfusion, and leukopenia (WBC was below 4×10 9/L).