再生障碍性贫血感染危险因素分析

Analysis of risk factors of infection in aplastic anemia

目的探讨再生障碍性贫血患者的感染特征及危险因素,为采取有效的防治措施提供理论依据。方法选取西南医科大学附属医院血液内科2013年5月~2017年5月收治的再生障碍性贫血患者330例为研究对象,采取回顾性调查分析方法分析患者的感染特征及其相关危险因素,应用SPSS 17.0软件进行统计学分析。结果 330例再生障碍性贫血患者中,住院期间发生感染共128例,感染率为38.8%,医院感染46例(35.9%),社区感染82例(64.1%),单一菌感染111例(86.7%),双重感染14例(10.9%),多重感染3例(2.4%)。共培养出病原菌19例,G-菌12例,占63.2%,G+菌4例,占21.1%,真菌3例,占15.7%。单因素分析显示,住院时间、白细胞计数、中性粒细胞计数、粒细胞缺乏持续时间、白蛋白含量、侵袭性操作、应用激素是再生障碍性贫血患者发生感染的危险因素(P<0.01),多因素分析显示,住院时间、粒细胞缺乏持续时间、白蛋白含量、中性粒细胞数量是再生障碍性贫血感染的独立危险因素(P<0.01)。结论在临床上,应针对以上的危险因素采取积极有效的预防措施,以降低再生障碍性贫血患者感染的发生率。

Objective To investigate the infection characteristics and risk factors of aplastic anemia patients to provide the theoretical basis for effective prevention and treatment.Methods 330 patients with aplastie anemia treated in the Hematology Department of Affiliated Hospital of Southwest Medical University from May 2013 to May 2017 were se- lected as object.Retrospective investigation and analysis method was used to analyze the related infection characteristics and the related risk factors of patients.Data were analyzed by SPSS 17.0 software.Results Among 330 patients with aplastic anemia,128 cases had infections （38.8%）,46 cases of hospital infection （35.9%）,82 cases of community infection （64.1%）,111 cases of single infection （86.7%）,14 cases of double infection （10.9%）,3 cases of multiple infection （2.4%）. A total of 19 cases of pathogenic bacteria were trained,Gram-negative bacteria in 12 case （63.2%）,Gram-positive bac- teria in 4 cases （21.1%）,fungal infections in 3 cases （15.7%）.Single factor analysis showed that the hospitalization time, white blood eel1 count,neutrophils count,agranulocytosis duration,albumin eontent,invasive operation and the application of hormone were risk factors for infection in patients with aplastic anemia （P〈O.O1）.Multivariate analysis showed that the hospitalization time,agranulocytosis duration,albumin content,number of neutrophils were independent risk factors for aplastic anemia with infection （P〈O.O1）.Conclusion In clinic,positive and effective preventive measures should be taken according to the above risk factors to reduce the incidence of infection in patients with aplastic anemia.