成年人原发免疫性血小板减少症继发感染166例特征及危险因素分析

Analysis of characteristics and risk factors related to adult patients of primary immune thrombocytopenia with infection

目的 分析成年人原发免疫性血小板减少症（ITP）患者继发感染的危险因素,为针对性的预防及治疗感染提供依据.方法 以2015年1月至2017年12月绍兴市人民医院就诊的166例成年人ITP患者为调查对象,采用回顾性调查方法对患者进行调查,数据采用SPSS 21.0统计学软件进行统计分析.结果 成年人ITP患者感染率为24.70％（41/166）,感染的危险因素为年龄（OR=1.290,P=0.011）、骨髓巨核细胞数（OR=1.220,P=0.022）、合并糖尿病（OR=2.163,P〈0.001）和糖皮质激素使用（OR=2.203,P〈0.001）,41例感染患者共检出致病原微生物45株,其中革兰阴性菌占51.11％（23/45）,革兰阳性菌占44.44％（20/45）,真菌占4.44％（2/45）.结论 多种因素与 ITP 患者感染相关,应对危险因素采取相关的防控措施,以降低 ITP 患者感染率.

Objective To analyze the risk factors related to adult patients of primary immune thrombocytopenia with infection,so as to provide basis for control and prevention of infection. Methods From January 2015 to December 2017,the clinical data of 166 adult patients of primary immune thrombocytopenia in the People＇s Hospital of Shaoxing-were retrospectively analyzed. Statistical analysis was performed by SPSS21. 0 statistical software. Results The infec-tion rate was 24. 70％ （41 / 166）. The risk factors related to infection were age（OR = 1. 290,P = 0. 011）,the number of bone marrow megakaryocytes（OR = 1. 220,P = 0. 022）,diabetes（OR = 2. 163,P 〈 0. 001） and glucocorticoid （OR =2. 203,P 〈0. 001）. There were 45 strains of pathogenic bacteria detected in 41 patients,gram negative bacteria accounted for 51. 11％ （23 / 45）,gram positive bacteria accounted for 44. 44％ （20 / 45）,and fungi accounted for 4. 44％ （2 / 45）. Conclusion A variety of factors are related to infection in adult primary immune thrombocytopenia patients. It is necessary to take effective prevention measure,which will help reduce the incidence of infection.