多发性骨髓瘤患者化疗后感染的研究

Research and analysis of infection after chemotherapy in patients with multiple myeloma

目的探讨多发性骨髓瘤患者化疗后感染的临床特点,为安全有效的临床治疗提供科学依据。方法回顾性分析2009年1月-2013年10月87例多发性骨髓瘤并发感染患者的临床资料;根据患者的病情发展分为两种治疗方案,VAD组45例与TD组42例,比较两组的感染情况,数据采用SPSS13.0进行统计分析。结果 87例多发性骨髓瘤患者化疗后发生感染的共有47例,感染率54.02%;VAD组45例患者,感染33例感染率73.33%;TD组42例患者,感染14例感染率33.33%;VAD组的感染率高于TD组的感染率,差异有统计学意义(P<0.01);发生部位以呼吸道、泌尿系统为主,两组方案的感染病死率比较,差异无统计学意义。结论多发性骨髓瘤化疗后易发生感染,不同的化疗方案以及化疗后骨髓抑制期中性粒细胞缺乏是发生感染的主要因素,因此为预防和控制化疗后感染,应合理选择化疗方案。

OBJECTIVE To explore the clinical features of infection after chemotherapy in patients with multiple myeloma ,and provide scientific basis for clinical safe and effective treatment .METHODS A retrospective analysis was conducted of the clinical data of 47 cases of multiple myeloma patients receiving treatment from Jan .2009 to Oct .2013 in our hospital .According to the patient′s condition ,two kinds of treatment were given and patients were divided into the VAD group and the TD group accordingly .Infection rates were compared between the two groups and data were statistically analyzed with the software SPSS 13 .0 .RESULTS There were 45 cases of infec‐tion in the 87 cases of multiple myeloma patients with the infection rate of 51 .72% ,including 33 cases in the 45 patients of the VAD group with the infection rate of 73 .33% and 14 cases in the 42 patients of the TD group with the infection rate of 33 .33% .The infection rate in the VAD group was higher than that in the TD group ,the difference was statistically significant （P〈0 .01） .The infection sites were mainly respiratory tract and urinary system .There was no significant difference in the mortality rate for infection between the two groups （P〉0 .05） . CONCLUSION Patients with multiple myeloma are prone to infection after chemotherapy .Different chemotherapy regimens and neutropenia during myelosuppression after chemotherapy are the major factors for infection .There‐fore ,a reasonable choice of chemotherapy should be made to prevent and control infection after chemotherapy .