预防性应用抗生素对糖皮质激素治疗老年ITP并发感染的影响

Effect of Preventative Application of Antibiotics on the Incidence of Infection in Elderly Patients with Idiopathic Thrombocytopenic Purpura Treated by Glucocorticoid

目的：探讨预防性应用抗生素对糖皮质激素治疗老年特发性血小板减少性紫癜并发感染的影响。方法：将哈尔滨医科大学附属第二医院血液科2012年3月-2015年3月的收治的72例老年特发性血小板减少性紫癜患者随机分为两组,自应用糖皮质激素第一天开始观察15天,观察组自应用糖皮质激素开始即使用抗生素,对照组不常规应用抗生素,以出现感染症状即开始应用抗生素,同时定为观察终止。比较两组患者感染发生率的差异。结果：观察组感染发生率为38.89%,对照组为69.44%,较观察组显著升高,差异有统计学意义（P〈0.05）。两组患者感染发生部分的分布情况比较无统计学差异（P〉0.05）,以呼吸系统感染发生率最高,其次是尿路感染。结论：预防性的使用抗生素可以降低糖皮质激素治疗老年特发性血小板减少性紫癜患者过程中感染的发生率。

Objective： To explore the effect of preventative application of antibiotics on the incidence of infection in elderly patients with idiopathic thrombocytopenic purpura treated by glucocorticoid. Methods： 72 elderly patients with idiopathic thrombocytopenic purpura admitted in the Department of Hematology of Second Affiliated Hospital of Harbin Medical University from March 2012 to March 2015 were randomly divided into two groups. the observation group was treated by antibiotics since the use of glucocorticoids, while the control group was treated by antibiotics when the signs of infection started. The incidence rate of infection was observed and compared between two groups. Results： The infection rate of observation group was 38.89%, which was 69.44% in the control group and significantly higher than that in the observation group（P〈0.05）. No statistical difference was found in the distribution infections part between two groups（P〈0.05）, with the highest incidence of respiratory system infection, followed by urinary tract infections. Conclusion： Prophylactic use of antibiotics could reduce the infection rate during glucocorticoid treatment of senile idiopathic thrombocytopenic purpura patients.