真菌血症患者血小板计数动态变化回顾分析

Retrospective analysis of blood platelet counts dynamic changes in fungemia patients

目的调查了解临床真菌血症患者血小板计数动态变化情况,分析其与真菌血流感染发生、发展和转归的关系。方法收集2011年10月至2013年5月白求恩国际和平医院住院患者中发生真菌血症患者的临床资料,分析血小板计数动态变化情况,对数据进行整理和统计分析。结果重症感染(50.00%)和恶性肿瘤(34.38%)是真菌血症患者最主要的基础疾病。32例真菌血症患者中17例(53.13%)发生血小板计数明显下降。血小板计数动态曲线形态呈现3种变化形态:平稳型(15例)、U型(10例)和L型(7例),其病死率分别为20.00%、20.00%和100.00%,3种血小板曲线形态患者预后差异有统计学意义(χ2=14.93,P<0.05)。结论在真菌血症患者中,发生血小板下降的概率较大。血小板下降,尤其是经治疗无法回升的患者往往病情凶险,应引起临床高度重视。

Objective To learn the blood platelet counts dynamic changes in fungemia patients, to explore the relationship between blood platelet counts and the occurrence, development and outcome of fungemia. Methods Clini‐cal data and blood platelet counts dynamic changes of the inpatients with fungemia in our hospital were collected （Oc‐tober 2011 to May 2013）, the data thus were evaluated and statistically processed. Results For fungemia patients, se‐vere infection （50. 00% ） and malignant tumors （34. 38% ） were the most common basic disease. In the 32 cases, we investigated that platelet counts decreased significant in 17 cases （counted for 53. 13% ）. Three types of platelet counts kinetic curve could observed in this study ：constant type （15 cases）, U type （10 cases）and L type（7 cases）, the mortality rate of the three types were 20. 00%, 20. 00% and 100. 00% and had a statistically significant difference （χ2 =14. 93, P〈 0. 05）. Conclusion There is a considerably high incidence of thrombocytopenia in fungemia pa‐tients. For fungemia patients, decreas platelet counts, especially those can′t recover after clinical therapy often pre‐cludes dangerous condition and poor prognosis.